Joann E Hollen, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

8109 Issued in KY

Practice address

240 Blossom Park Dr
Suite 2
Georgetown, KY 40324-9079

Phone

(502) 570-8841

Fax

(502) 570-8891

NPI assigned

Nov 20, 2006

Sex

Female

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

Enrolled in KY

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

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Dental Professional of Kentucky PSC

  dba Blossom Park Dental Care

  • Dentist
  • Georgetown, KY
  • NPI 1912060351
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437223674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 BLOSSOM PARK DR",
            "address_2": "SUITE 2",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249079",
            "telephone_number": "502-570-8841",
            "fax_number": "502-570-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 BLOSSOM PARK DR",
            "address_2": "SUITE 2",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249079",
            "telephone_number": "502-570-8841",
            "fax_number": "502-570-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEN",
        "first_name": "JOANN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60002748",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• David M. Hoddy, M.D.
• Joseph Michael Holmes, PT, DPT
• Charisse Nirvanna Holt
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• Nancy Elizabeth Houser, LMT
• Caitlyn Howard

• Dentist in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Dentist in Kentucky

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.