Individual provider Active NPI

Jess Lee Holler, D.D.S.

  • General Practice Dentistry
  • Terre Haute, IN
National Provider Identifier
1326087511
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12007999 Issued in IN
Practice address
1024 Lafayette Ave
Terre Haute, IN 47804-2932
Phone
(812) 232-6654
Fax
(812) 232-4255
NPI assigned
Jun 5, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 12007999 IN Primary

Addresses

Primary practice location

1024 Lafayette Ave
Terre Haute, IN 47804-2932

Mailing address

1024 Lafayette Ave
Terre Haute, IN 47804-2932
Phone (812) 232-6654

Other identifiers 1

IdentifierTypeStateIssuer
184293OtherINUNITED CONDORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20150603002676 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4183945074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12007999INMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1326087511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 LAFAYETTE AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042932",
            "telephone_number": "812-232-6654",
            "fax_number": "812-232-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 LAFAYETTE AVE",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478042932",
            "telephone_number": "812-232-6654",
            "fax_number": "812-232-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLER",
        "first_name": "JESS",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONDORDIA",
            "identifier": "184293",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

Verify at the official NPI Registry.