Active NPI
John Robert Holt, DDS
- Dental Anesthesiology
- Lubbock, TX
National Provider Identifier
1336125384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- 15567
- Practice address
- 2309 York Ave
Lubbock, TX 79407-2286 - Phone
- (806) 783-0520
- Fax
- (806) 783-0674
- NPI assigned
- Dec 21, 2005
- Last updated
- Nov 19, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 15567 | TX | |
| Dental Anesthesiology | 1223D0004X | 15567 | TX | Primary |
Addresses
Primary practice location
2309 York Ave
Lubbock, TX 79407-2286
Mailing address
2309 York Ave
Lubbock, TX 79407-2286
Phone (806) 783-0520
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0902165 | Medicaid | TX | |
| 75-2277547 | Other | TX | FEDERAL TAX ID |
| K53H | Other | TX | BLUE CROSS BLUE SHIELD |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15567 | TX | MD | Dentist Anesthesiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384819200000",
"number": "1336125384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2309 YORK AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794072286",
"telephone_number": "806-783-0520",
"fax_number": "806-783-0674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2309 YORK AVE",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794072286",
"telephone_number": "806-783-0520",
"fax_number": "806-783-0674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "JOHN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-21",
"last_updated": "2013-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "15567",
"primary": false
},
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "TX",
"license": "15567",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0902165",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID",
"identifier": "75-2277547",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "K53H",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
- Audry Hollis, LPC-A
- Holly S. Stewart, MD PA
- Stephen Russell Holmes, MD
- April Denise Holsey, PT
- Avery Grace Holt
- Robert Holton, CCC/SLP
- Home Health Partnership Operating Company, L.L.C. (UMC Home Health and Hospice, an Amedisys Partner)
- Home Oxygen & Equipment Co Inc
- Homecare Solutions of Lubbock, Inc.
- Dean Edward Homen, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.