Individual provider Active NPI

John Karl Holzinger, DMD

  • Dentist
  • Middletown, CT
National Provider Identifier
1508976374
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
05923 Issued in CT
Practice address
770 Saybrook Rd
Middletown, CT 06457
Phone
(860) 347-8457
Fax
(860) 347-4393
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 05923 CT Primary

Addresses

Primary practice location

770 Saybrook Rd
Middletown, CT 06457

Mailing address

60 Walden Court
Berlin, CT 06037
Phone (860) 828-0728

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
05923CTMDDentist
5923CTMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508976374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 WALDEN COURT",
            "city": "BERLIN",
            "state": "CT",
            "postal_code": "06037",
            "telephone_number": "860-828-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 SAYBROOK RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "06457",
            "telephone_number": "860-347-8457",
            "fax_number": "860-347-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLZINGER",
        "first_name": "JOHN",
        "middle_name": "KARL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "05923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • 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.