Danny Jack Holtzclaw, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

20329 Issued in TX

Practice address

4010 Sandy Brook Dr Ste 204
Round Rock, TX 78665-1518

Phone

(512) 375-0500

Fax

(512) 682-9009

NPI assigned

Apr 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1669434650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 SANDY BROOK DR STE 204",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651518",
            "telephone_number": "512-375-0050",
            "fax_number": "512-682-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 SANDY BROOK DR STE 204",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651518",
            "telephone_number": "512-375-0500",
            "fax_number": "512-682-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTZCLAW",
        "first_name": "DANNY",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20329",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "20329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen I. Holmes, PA
• Olivia Holmes, PNP
• Molly Holody
• Kandi Holt
• Shelby Jessica Holt, DC
• Katie Benjegerdes Homan, MD
• Anna Rose Honea, CF-SLP
• Rachelle Honohan, LCSW
• Jenna Honorable, OTR/L
• Roy Bolden Hooks Jr., D.D.S.

• Periodontics in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.