Richard Stephen Holba, D.D.S10

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19014582 Issued in IL

Practice address

1700 Ravinia PL
Orland Park, IL 60462-3543

Phone

(708) 349-3637

Fax

(708) 449-4379

NPI assigned

Oct 22, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1467604397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 RAVINIA PL",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623543",
            "telephone_number": "708-349-3637",
            "fax_number": "708-349-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 RAVINIA PL",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623543",
            "telephone_number": "708-349-3637",
            "fax_number": "708-449-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBA",
        "first_name": "RICHARD",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S10",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19014582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Thomas Hofferica
• Donald R Hoffman, DPM
• Deirdre Megan Hofman, PA-C
• Karolina Hogueisson, LCPC, NCC
• John G Hohner, D.O.
• Alexandra Holdefer, LCSW, CADC
• Rudi Holland, OTR
• Joshua Raphael Hollie, BEHAVIOR ANALYST
• India Hollinquest, MSN, APRN, FNP-BC
• Jordan Barnhill Holloran, LSW

• General Practice Dentistry in Orland Park, IL
• Providers in Orland Park, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.