Andy S. Holtery, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN16362 Issued in FL

Practice address

136 Partin Dr N
Niceville, FL 32578-2054

Phone

(850) 678-7114

NPI assigned

Mar 21, 2006

Sex

Male

Sole proprietor

Yes

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 Jan 26, 2016 through Jan 26, 2028

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Sharon S Chen DDS PA

  • Dentist
  • Niceville, FL
  • NPI 1700973781
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1639138498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6028 STERLING RIVER WAY",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781535",
            "telephone_number": "407-310-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 PARTIN DR N",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782054",
            "telephone_number": "850-678-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTERY",
        "first_name": "ANDY",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN16362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Jackson Holcombe, CRNA
• Holiday CVS LLC (CVS Pharmacy 04612)
• Holiday CVS LLC (CVS Pharmacy #05178)
• Deborah Joy Hollis, LMHC-S
• Alexia Holt
• Ronald Holthaus, PT
• Kathleen Hood, D.D.S.
• Shanna Horn
• Ladd M Horvath, DDS
• Bryan Nelson House, DDS

• General Practice Dentistry in Niceville, FL
• Providers in Niceville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.