Individual provider Active NPI

J Greg Holm, D.D.S., P.A.

  • Dentist
  • Wichita, KS
National Provider Identifier
1467451633
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6378 Issued in KS
Practice address
7405 W Central Ave
Wichita, KS 67212-3514
Phone
(316) 722-3191
Fax
(316) 722-7827
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6378 KS Primary

Addresses

Primary practice location

7405 W Central Ave
Wichita, KS 67212-3514

Mailing address

7405 W Central Ave
Wichita, KS 67212-3514
Phone (316) 722-3191

Other identifiers 1

IdentifierTypeStateIssuer
22817OtherKSBLUE CROSS PROVIDER #

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6378KSMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1467451633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7405 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123514",
            "telephone_number": "316-722-3191",
            "fax_number": "316-722-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7405 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123514",
            "telephone_number": "316-722-3191",
            "fax_number": "316-722-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLM",
        "first_name": "J",
        "middle_name": "GREG",
        "credential": "D.D.S., P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "6378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "22817",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.