Kenneth Alan Holman, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

23516 Issued in CA

Practice address

52 Arch St
Suite No 2
Redwood City, CA 94062-1469

Phone

(650) 366-5758

Fax

(650) 366-0714

NPI assigned

Jun 12, 2012

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 1, 2015 through Aug 1, 2027

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Kenneth a Holman DDS Inc

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Redwood City, CA
  • NPI 1427111566
  NPD (past) Authorized official

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1326300773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 ARCH ST",
            "address_2": "SUITE NO 2",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940621469",
            "telephone_number": "650-366-5758",
            "fax_number": "650-366-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 ARCH ST",
            "address_2": "SUITE NO 2",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940621469",
            "telephone_number": "650-366-5758",
            "fax_number": "650-366-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "23516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy R Holecheck
• Jeffrey Duncan Holeman
• Susan Holland, PT
• Frederic G Holloszy II, DMD
• Lucia Taylor Hollowell, LCSW, APHSW-C
• Kendra Bell Holmes
• Kevin Holtman, O.D.
• Daniel Jason Holtzman, M.D.
• Shawna Elaine Homen
• Victoria A Hoobyar, M.S., MFT

• Orthodontics and Dentofacial Orthopedics Dentistry in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.