Active NPI
Robert D Holland Jr., D.M.D.
- Prosthodontics
- Columbia, SC
National Provider Identifier
1588732895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 2991
- Practice address
- 4019 Forest Dr
Columbia, SC 29204-4313 - Phone
- (803) 787-5445
- Fax
- (803) 787-5416
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 2991 | SC | Primary |
Addresses
Primary practice location
4019 Forest Dr
Columbia, SC 29204-4313
Mailing address
4019 Forest Dr
Columbia, SC 29204-4313
Phone (803) 787-5445
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160108002179 | SC | Order and Referring Only - Oral Surgery | 4688976574 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260921600000",
"number": "1588732895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4019 FOREST DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292044313",
"telephone_number": "803-787-5445",
"fax_number": "803-787-5416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4019 FOREST DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292044313",
"telephone_number": "803-787-5445",
"fax_number": "803-787-5416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLAND",
"first_name": "ROBERT",
"middle_name": "D",
"name_suffix": "Jr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2009-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "SC",
"license": "2991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.