Active NPI
Michael Holt, DDS
- Pediatric Dentistry
- Charlotte, NC
National Provider Identifier
1376563098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 7369
- Practice address
- 9601 Brookdale Dr
Suite 400
Charlotte, NC 28215-8725 - Phone
- (704) 599-3901
- Fax
- (704) 213-3119
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 7369 | NC | Primary |
Addresses
Primary practice location
9601 Brookdale Dr
Suite 400
Charlotte, NC 28215-8725
Mailing address
9601 Brookdale Dr
Suite 400
Charlotte, NC 28215-8725
Phone (704) 599-3901
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015N0 | Other | NC | NC HEALTHCHOICE |
| 5901086 | Medicaid | NC |
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 |
|---|---|---|---|
| 7369 | NC | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kelley and Holt PLLC | Pediatric Dentistry | Past | Accepting new patients |
Interoperability endpoints
- mholt537131@carolinashealthcaresystem.direct-ci.com
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.
-
dba Brookdale Pediatric Dentistry
- Pediatric Dentistry
- Charlotte, NC
- NPI 1962745992
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364774400000",
"number": "1376563098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9601 BROOKDALE DR",
"address_2": "SUITE 400",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282158725",
"telephone_number": "704-599-3901",
"fax_number": "704-213-3119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9601 BROOKDALE DR",
"address_2": "SUITE 400",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282158725",
"telephone_number": "704-599-3901",
"fax_number": "704-213-3119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2013-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NC",
"license": "7369",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC HEALTHCHOICE",
"identifier": "015N0",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5901086",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.