Active NPI
Adam Michael Holder, D.D.S.
- Dentist
- Hinckley, MN
National Provider Identifier
1609169762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D12924
- Practice address
- 302 Fire Monument Rd
Hinckley, MN 55037-8350 - Phone
- (320) 384-6118
- NPI assigned
- May 24, 2011
- Last updated
- May 5, 2017
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D12924 | MN | Primary |
Addresses
Primary practice location
302 Fire Monument Rd
Hinckley, MN 55037-8350
Mailing address
220 3Rd St. W
Carver, MN 55315-4556
Phone (218) 839-0873
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- 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 |
|---|---|---|---|---|
| I20150504002064 | MN | Order and Referring Only - Oral Surgery | 3870812415 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Modern Dental Professionals MN PC | Dentist | Past | Accepting new patients |
| Carver Dental PA | Past | Accepting new patients | |
| Hinckley Dental Center P. a. | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Dental Clinic/Center
- Carver, MN
- NPI 1528508348
-
- General Practice Dentistry
- Hinckley, MN
- NPI 1437138583
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493942400000",
"number": "1609169762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 3RD ST. W",
"city": "CARVER",
"state": "MN",
"postal_code": "553154556",
"telephone_number": "218-839-0873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "302 FIRE MONUMENT RD",
"city": "HINCKLEY",
"state": "MN",
"postal_code": "550378350",
"telephone_number": "320-384-6118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLDER",
"first_name": "ADAM",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-24",
"last_updated": "2017-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D12924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hinckley, MN
- Stephanie Alexis Hanowski
- Darnell Jean Hendrickson, OCCUPATIONAL THERAPI
- Hinckley Assisted Living LLC. (Elderwood of Hinckley)
- Hinckley Dental Center P. a.
- Hinckley Drug LLC
- Jodel Hunt, IHP
- Independent School District 2165
- Kyle Hams D.C. P.a. (Hinckley Chiropractic)
- Gerard Lawrence Lafave, MA, LMFT
- Kari Loew, PT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; 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.