J. Greg Holm D.D.S.,P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6378 Issued in KS

Legal business name

J. GREG HOLM D.D.S.,P.A.

Practice address

7405 W Central Ave
Wichita, KS 67212-3514

Phone

(316) 722-3191

Fax

(316) 722-7824

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

Kim A Wehmeyer

Title

Office Manager

Phone

(316) 722-3191

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1699727388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7405 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123514",
            "telephone_number": "316-722-3191",
            "fax_number": "316-722-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7405 W CENTRAL AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672123514",
            "telephone_number": "316-722-3191",
            "fax_number": "316-722-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. GREG HOLM D.D.S.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "WEHMEYER",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "316-722-3191"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "6378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1467451633",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. GUST IND NPI NUMBER",
            "identifier": "1336128990",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BC NUMBER",
            "identifier": "421771",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR GUST LIC NUMBER",
            "identifier": "60340",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LIC NUMBER",
            "identifier": "6378",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC PROVIDER NUMBER",
            "identifier": "116941",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. GUST BC NUMBER",
            "identifier": "116942",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Wichita, KS
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.