Active NPI
Cynthia Renee Holliday, D.D.S.
- Dentist
- Jacksonville, FL
National Provider Identifier
1598047888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 60756
- Practice address
- 2005 Knight Lane BLDG H
Navy Medicine Support Attn: Medical Staff Services
Jacksonville, FL 32212-0140 - Phone
- (559) 334-7788
- NPI assigned
- Sep 13, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 60756 | CA | Primary |
Addresses
Primary practice location
2005 Knight Lane BLDG H
Navy Medicine Support Attn: Medical Staff Services
Jacksonville, FL 32212-0140
Mailing address
790 Camino de la Reina Apt 176
San Diego, CA 92108-3273
Phone (559) 334-7788
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 |
|---|---|---|---|
| 60756 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315872000000",
"number": "1598047888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 CAMINO DE LA REINA APT 176",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083273",
"telephone_number": "559-334-7788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2005 KNIGHT LANE BLDG H",
"address_2": "NAVY MEDICINE SUPPORT ATTN: MEDICAL STAFF SERVICES",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322120140",
"telephone_number": "559-334-7788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLIDAY",
"first_name": "CYNTHIA",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-13",
"last_updated": "2011-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "60756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.