Active NPI
Dylan Edward Holtman, DMD
- General Practice Dentistry
- Thomasville, GA
National Provider Identifier
1568974483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN015516
- Practice address
- 428 Remington Ave
Thomasville, GA 31792-5525 - Phone
- (292) 268-4812
- NPI assigned
- Nov 1, 2017
- Last updated
- Oct 30, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN015516 | GA | Primary |
Addresses
Primary practice location
428 Remington Ave
Thomasville, GA 31792-5525
Mailing address
3896 Bettys PL
Hahira, GA 31632-2770
Phone (770) 845-0189
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN015516 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730246400000",
"number": "1568974483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3896 BETTYS PL",
"city": "HAHIRA",
"state": "GA",
"postal_code": "316322770",
"telephone_number": "770-845-0189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "428 REMINGTON AVE",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317925525",
"telephone_number": "292-268-4812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLTMAN",
"first_name": "DYLAN",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-01",
"last_updated": "2024-10-30",
"certification_date": "2024-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN015516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Thomasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.