Active NPI
J. Gordon Holyoak, D.D.S.
- Dentist
- Phoenix, AZ
National Provider Identifier
1104972041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1240
- Practice address
- 3409 N 56TH St
Suite a
Phoenix, AZ 85018-6150 - Phone
- (480) 994-5557
- Fax
- (480) 994-9439
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1240 | AZ | Primary |
Addresses
Primary practice location
3409 N 56TH St
Suite a
Phoenix, AZ 85018-6150
Mailing address
3409 N 56TH St
Suite a
Phoenix, AZ 85018-6150
Phone (480) 994-5557
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1240 | AZ | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Design of Arcadia | Past | Accepting new patients | |
| Arcadia Az Dentistry | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Phoenix, AZ
- NPI 1922787654
-
- General Practice Dentistry
- Phoenix, AZ
- NPI 1558412635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104972041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3409 N 56TH ST",
"address_2": "SUITE A",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850186150",
"telephone_number": "480-994-5557",
"fax_number": "480-994-9439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3409 N 56TH ST",
"address_2": "SUITE A",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850186150",
"telephone_number": "480-994-5557",
"fax_number": "480-994-9439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLYOAK",
"first_name": "J. GORDON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "1240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.