Trevor Holleman, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D1200 Issued in SD

Practice address

1700 S Southeastern Ave
Sioux Falls, SD 57103

Phone

(605) 331-5059

Fax

(605) 275-6725

NPI assigned

Apr 15, 2014

Last updated

Aug 21, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 27, 2018 through Jun 27, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• River Ridge Oral & Maxillofacial Surgical Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Sioux Falls, SD
  • NPI 1376522714
  NPD (past)

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1588083711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S SOUTHEASTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571033227",
            "telephone_number": "605-331-5059",
            "fax_number": "605-275-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S SOUTHEASTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57103",
            "telephone_number": "605-331-5059",
            "fax_number": "605-275-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEMAN",
        "first_name": "TREVOR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SD",
            "license": "D1200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Holden, RD
• Ashley Holen, NP-C
• Marshall I Holifield, M.D.
• Kelsey A Holkesvik, MD
• Kari Holland
• Troy Dean Hollinsworth, MD
• Cassidy L Hollon
• Mackenzie Margaret Holm-Moffitt, PA-C
• Aleisha Holm, FNP-C
• Alexander James Holm, MD

• Oral and Maxillofacial Surgery (Dentist) in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Oral and Maxillofacial Surgery (Dentist) in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.