Individual provider Active NPI

Paul Michael Holliday, DDS

  • General Practice Dentistry
  • Chattanooga, TN
National Provider Identifier
1619033834
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8102 Issued in TN
Practice address
537 Market St
Suite 301
Chattanooga, TN 37402-1225
Phone
(423) 756-4448
Fax
(423) 756-4450
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8102 TN Primary

Addresses

Primary practice location

537 Market St
Suite 301
Chattanooga, TN 37402-1225

Mailing address

537 Market St
Suite 301
Chattanooga, TN 37402-1225
Phone (423) 756-4448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161201001132 TN Order and Referring Only - DentistPractitioner - Dentist 9335429794

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8102TNMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619033834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 MARKET ST",
            "address_2": "SUITE 301",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374021225",
            "telephone_number": "423-756-4448",
            "fax_number": "423-756-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 MARKET ST",
            "address_2": "SUITE 301",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374021225",
            "telephone_number": "423-756-4448",
            "fax_number": "423-756-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.