Individual provider Active NPI

M Brett Holliday, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Santa Fe, NM
National Provider Identifier
1679771976
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DD1994 Issued in NM
Practice address
551 W Cordova Rd
Santa Fe, NM 87505-1825
Phone
(505) 820-6776
NPI assigned
Jul 7, 2007
Last updated
Dec 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DD1994 NM Primary

Addresses

Primary practice location

551 W Cordova Rd
Santa Fe, NM 87505-1825

Mailing address

157 W Zia Rd
Santa Fe, NM 87505-5750
Phone (505) 820-6776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20150803000885 NM Order and Referring Only - DentistPractitioner - Dentist 8123332277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1183766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1679771976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 W ZIA RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055750",
            "telephone_number": "505-820-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 W CORDOVA RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875051825",
            "telephone_number": "505-820-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "M",
        "middle_name": "BRETT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-07",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NM",
            "license": "DD1994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.