Individual provider Active NPI

Colleen Holewa, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Newtown, PA
National Provider Identifier
1548654049
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS043013 Issued in PA
Practice address
102 Fair Oaks CT
Newtown, PA 18940-2353
Phone
(508) 353-1233
NPI assigned
Mar 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 51032 NC
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS043013 PA Primary

Addresses

Primary practice location

102 Fair Oaks CT
Newtown, PA 18940-2353

Mailing address

102 Fair Oaks CT
Newtown, PA 18940-2353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20240118002879 SC Practitioner - Oral Surgery 7810216124 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51032NCMDDentist
DS043013PAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Nov 21, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Nov 21, 2023 Accepting new patients
Charleston Jaw Surgery PastSince Sep 6, 2020 Accepting new patients
University Neurosurgical, PC PastSince Aug 1, 2021 Accepting new patients

Locations

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1548654049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 FAIR OAKS CT",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189402353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 FAIR OAKS CT",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189402353",
            "telephone_number": "508-353-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLEWA",
        "first_name": "COLLEEN",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-23",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "51032",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS043013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, PA

Sources for this page

Verify at the official NPI Registry.