Individual provider Active NPI

Lindsay Ann Holman, D.D.S.

  • General Practice Dentistry
  • Livonia, MI
National Provider Identifier
1336494954
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901020688 Issued in MI
Practice address
32280 Five Mile Rd
Livonia, MI 48154-6112
Phone
(734) 425-7010
NPI assigned
Jul 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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 2901020688 MI Primary

Addresses

Primary practice location

32280 Five Mile Rd
Livonia, MI 48154-6112

Mailing address

32280 Five Mile Rd
Livonia, MI 48154-6112
Phone (734) 425-7010

Other names 1

  • Ms. Lindsay Ann Rayburn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150507002624 MI Order and Referring Only - DentistPractitioner - Dentist 8426377797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901020688MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel S Fox, DDS, PLLC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1336494954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32280 FIVE MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481546112",
            "telephone_number": "734-425-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32280 FIVE MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481546112",
            "telephone_number": "734-425-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "LINDSAY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "RAYBURN",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.