Holly Ann Gorsen, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02418000 Issued in NJ

Practice address

1017 East Landis Ave
Vineland, NJ 08360

Phone

(856) 692-4670

Fax

(856) 692-3068

NPI assigned

Oct 29, 2009

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 names 1

• Dr. Holly Ann Eldridge Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1447586243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 EAST LANDIS AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "08360",
            "telephone_number": "856-692-4670",
            "fax_number": "856-692-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 EAST LANDIS AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "08360",
            "telephone_number": "856-692-4670",
            "fax_number": "856-692-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORSEN",
        "first_name": "HOLLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-29",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02418000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "ELDRIDGE",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "DMD.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Kristine Gonzalez, PA-C
• Destiny Marie Gonzalez
• Courtney Nicole Good, LSW
• Marina Gordeyeva, O.D.
• Paige M Gorgo
• Melvyn N Gorsen, D.D.S.,P.A.
• Michael Seth Gorsen, D.D.S
• Wallena M Gould, CRNA
• Kayla Lanae Grablow, MA, LAC
• John W Graham, PT

• Dentist in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.