Organization Active NPI

Holden Dental Associates, Inc.

  • Dentist
  • Orlando, FL
National Provider Identifier
1730200627
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
HOLDEN DENTAL ASSOCIATES, INC.
Practice address
4638 S Orange Blossom TRL
Orlando, FL 32839-1706
Phone
(407) 858-0321
NPI assigned
Apr 2, 2007
Last updated
May 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Dr. Ivan Graham
Title
Vice President
Phone
(407) 858-0321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

4638 S Orange Blossom TRL
Orlando, FL 32839-1706

Mailing address

4638 S Orange Blossom TRL
Orlando, FL 32839-1706

Other identifiers 1

IdentifierTypeStateIssuer
070850000MedicaidFL

National Provider Directory

National Provider Directory

Locations

4638 S Orange Blossom Trl
Orlando, FL 32839
Phone (407) 251-2223

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1730200627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4638 S ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328391706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4638 S ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328391706",
            "telephone_number": "407-858-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLDEN DENTAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "IVAN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "407-858-0321",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070850000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.