Michael Edward Holub, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D009037 Issued in AZ

Practice address

21582 S Ellsworth Loop Rd Ste 126
Queen Creek, AZ 85142-7882

Phone

(480) 888-1416

NPI assigned

Aug 20, 2012

Last updated

Feb 27, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peach Tree Dental Group, LLP

  dba Peach Tree Dental Group

  • General Practice Dentistry
  • Queen Creek, AZ
  • NPI 1154580645
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1164770392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21582 S ELLSWORTH LOOP RD STE 126",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427882",
            "telephone_number": "480-888-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21582 S ELLSWORTH LOOP RD STE 126",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427882",
            "telephone_number": "480-888-1416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLUB",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-20",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D009037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Hodgkinson-Hamm
• Cassandra Hodo, NP-C
• Madeline Hoerner, DPT
• Ashley Nicole Hoetzlein
• Tracy Holman-Speights, NP
• Erica Holwager
• Honorhealth Medical Group, LLC
• Thomas James Hooker, MSN, APRN, FNP-C
• Douglas F Hoose, RDCS RVS
• Horizon Health & Wellness, Inc.

• Dentist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.