Organization Active NPI

Holly Springs Family Dentistry

  • Dentist
  • Holly Springs, NC
National Provider Identifier
1265604193
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7601 Issued in NC
Legal business name
HOLLY SPRINGS FAMILY DENTISTRY
Practice address
190 Rosewood Center Drive
Suite 200
Holly Springs, NC 27540
Phone
(919) 290-2772
Fax
(919) 270-2773
NPI assigned
Apr 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Authorized official

Name
Mr. Matthew Austin Taylor
Title
Practice Manager
Phone
(919) 290-2772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 7601 NC Primary

Addresses

Primary practice location

190 Rosewood Center Drive
Suite 200
Holly Springs, NC 27540

Mailing address

190 Rosewood Center Drive
Suite 200
Holly Springs, NC 27540
Phone (919) 290-2772

Other identifiers 1

IdentifierTypeStateIssuer
89902VVMedicaidNC

National Provider Directory

National Provider Directory

Locations

190 Rosewood Centre Dr
Ste 200
Holly Springs, NC 27540
Phone (919) 290-2772

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219104000000",
    "number": "1265604193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 ROSEWOOD CENTER DRIVE",
            "address_2": "SUITE 200",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "27540",
            "telephone_number": "919-290-2772",
            "fax_number": "919-270-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 ROSEWOOD CENTER DRIVE",
            "address_2": "SUITE 200",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "27540",
            "telephone_number": "919-290-2772",
            "fax_number": "919-270-2773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY SPRINGS FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-08-19",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "919-290-2772",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "7601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89902VV",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.