Active NPI
Marie Antoinette Holliday, D.M.D
- Dentist
- Fort Worth, TX
National Provider Identifier
1528282845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 11949
- Practice address
- 115 W 2ND St
Suite 200
Fort Worth, TX 76102-3000 - Phone
- (817) 877-1872
- Fax
- (817) 877-1874
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 11949 | TX | Primary |
Addresses
Primary practice location
115 W 2ND St
Suite 200
Fort Worth, TX 76102-3000
Mailing address
115 W. 2ND Suite #200
Fort Worth, TX 76102
Phone (817) 877-1872
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528282845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 W. 2ND SUITE #200",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76102",
"telephone_number": "817-877-1872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 W 2ND ST",
"address_2": "SUITE 200",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761023000",
"telephone_number": "817-877-1872",
"fax_number": "817-877-1874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLIDAY",
"first_name": "MARIE",
"middle_name": "ANTOINETTE",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "11949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
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.