Rusel Paul Hollister, D.D.S, M.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2901012996 Issued in MI

Practice address

4426 W KL Ave
Kalamazoo, MI 49006-5723

Phone

(269) 353-7700

Fax

(269) 353-7788

NPI assigned

Sep 28, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Arcadia Dental, P. C.

  • Dentist
  • Kalamazoo, MI
  • NPI 1457442766
  NPD (past) Authorized official

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487745774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4426 W KL AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490065723",
            "telephone_number": "269-353-7700",
            "fax_number": "269-353-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4426 W KL AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490065723",
            "telephone_number": "269-353-7700",
            "fax_number": "269-353-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLISTER",
        "first_name": "RUSEL",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901012996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Jones Hollings, M.D.
• Nicole Hollins, M.A., BCBA, LBA
• Mary Lou Hollis, ED.D.
• Hollister Audiology Services PLLC
• Kimberley Sue Hollister, AUD,CCC/A
• Lindsay Holloman
• J Saint Clair Holloway II
• Rojuan Holloway
• Lacey Holman
• Larreisha D Holman

• Dentist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Dentist in Michigan

• 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.

Verify at the official NPI Registry.