Tiffany Favero Holladay, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

57359 Issued in CA

Practice address

2237 Park Towne Cir
Suite 1
Sacramento, CA 95825-0417

Phone

(916) 487-9100

NPI assigned

Jan 13, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Tiffany Nicole Holladay Other name

Medicare fee-for-service enrollment

Enrolled in CA

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

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1558508531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2237 PARK TOWNE CIR",
            "address_2": "SUITE 1",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958250417",
            "telephone_number": "916-487-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2237 PARK TOWNE CIR",
            "address_2": "SUITE 1",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958250417",
            "telephone_number": "916-487-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLADAY",
        "first_name": "TIFFANY",
        "middle_name": "FAVERO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-13",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "HOLLADAY",
            "middle_name": "NICOLE",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Samantha Holguin
• Serena Holguin
• Veronica Holiday
• Holistic Family Services
• Holistic Postpartum Co
• Ana-Naomi Racataian Holland, MD
• Avery D Holland
• Lisa Marie Holland, REGISTERED NURSE
• Lorne L Holland, MD
• Madison Holland, MD

• General Practice Dentistry in Sacramento, CA
• Providers in Sacramento, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.