Jack Hollingsworth, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DS016011L Issued in PA

Practice address

3223 N Broad St
Philadelphia, PA 19140-5007

Phone

(215) 707-2880

NPI assigned

Nov 15, 2016

Last updated

Nov 15, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Temple University Kornberg School of Dentisyry

  • Dental Clinic/Center
  • Philadelphia, PA
  • NPI 1174902530
  NPD (past)
• Temple University School of Dentistry

  • Dental Clinic/Center
  • Philadelphia, PA
  • NPI 1245772318
  NPD (past)

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1336681816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 10TH ST",
            "address_2": "UNIT J",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471252",
            "telephone_number": "215-629-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINGSWORTH",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS016011L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA DENTIST LICENSE",
            "identifier": "DS016011L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Jean Holliman, PH.D.
• Bryan R. Hollinger, M.D., M.P.H., A.P.C.
• Joshua Kevin Hollinger, D.P.M.
• Judy J Hollinger
• Ruby Christine Hollinger, MD
• Megan Hollingsworth, PHARM.D
• Genevieve Ann Hollis, CRNP
• Jerome Hollomon, LSW
• Julieta Holloway James, RN Holloway-James
• Ebony L Holloway

• Dentist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.