Individual provider Active NPI

Susan I Holiday, DMD

  • General Practice Dentistry
  • Spring Valley, NY
National Provider Identifier
1194939355
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI016326 Issued in NJ
Practice address
102 McNamara Rd
Spring Valley, NY 10977-1406
Phone
(845) 354-1565
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DI016326 NJ Primary

Addresses

Primary practice location

102 McNamara Rd
Spring Valley, NY 10977-1406

Mailing address

102 McNamara Rd
Spring Valley, NY 10977-1406
Phone (845) 354-1565

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI016326NJMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: sholiday51509@northwell.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242172800000",
    "number": "1194939355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MCNAMARA RD",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109771406",
            "telephone_number": "845-354-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MCNAMARA RD",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109771406",
            "telephone_number": "845-354-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLIDAY",
        "first_name": "SUSAN",
        "middle_name": "I",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2009-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI016326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.