Kimberly Jacobsen Holliday, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3323 Issued in SC

Practice address

384 St Andrews Rd
Columbia, SC 29210-4427

Phone

(803) 772-9994

Fax

(803) 772-7736

NPI assigned

Jan 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kimberly Dawn Jacobsen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Family Dental Health of Seven Oaks LLC

  • General Practice Dentistry
  • Columbia, SC
  • NPI 1891436499
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285788604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 AMSTAR ROAD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292128270",
            "telephone_number": "803-732-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 ST ANDREWS RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292104427",
            "telephone_number": "803-772-9994",
            "fax_number": "803-772-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "KIMBERLY",
        "middle_name": "JACOBSEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "JACOBSEN",
            "middle_name": "DAWN",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Carter Holleman Jr., M.D.
• Austin D Holley, PT, DPT
• Zachary Holley
• Jacob Elvin Holliday, PHARMD
• Jennifer Holliday
• Lauren S Holliday, MD
• Tara R Holliday
• Adam M Hollien, ATC, SCAT
• Luke Hollingsworth
• Stephanie F Hollingsworth, APRN

• General Practice Dentistry in Columbia, SC
• Providers in Columbia, SC by specialty
• General Practice Dentistry in South Carolina

• 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.

Verify at the official NPI Registry.