Active NPI
Isaac Faxon Holton Jr., D.M.D.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Augusta, GA
National Provider Identifier
1417039280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 8610
- Practice address
- 1214 W Medical Park Rd
Augusta, GA 30909-4503 - Phone
- (706) 860-7937
- Fax
- (706) 860-9770
- NPI assigned
- Oct 20, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 8610 | GA | Primary |
Addresses
Primary practice location
1214 W Medical Park Rd
Augusta, GA 30909-4503
Mailing address
1214 W Medical Park Rd
Augusta, GA 30909-4503
Phone (706) 860-7937
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 |
|---|---|---|---|
| 8610 | GA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417039280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1214 W MEDICAL PARK RD",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309094503",
"telephone_number": "706-860-7937",
"fax_number": "706-860-9770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1214 W MEDICAL PARK RD",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309094503",
"telephone_number": "706-860-7937",
"fax_number": "706-860-9770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLTON",
"first_name": "ISAAC",
"middle_name": "FAXON",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "GA",
"license": "8610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
- Laura Lynn Holshouser, DPT
- Daniel Sean Holsonback, CNIM
- Amy Holsten, PH.D.
- Mary-Grace Elizabeth Holt
- Holton Physical Therapy and Performance Coaching, LLC
- Rhonda L. Holton, NNP
- Deborah Roos Holtzclaw, M.D.
- Nichole Marie Holweg, DO
- James Columbus Holyfield III, LMT
- Home Delivery Incontinent Supplies Co Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.