Active NPI
Keith A Holm, DMD
- General Practice Dentistry
- Litchfield Park, AZ
National Provider Identifier
1730210980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D7138
- Practice address
- 5609 N 132ND Dr
Litchfield Park, AZ 85340-8331 - Phone
- (623) 251-9767
- NPI assigned
- Mar 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D7138 | AZ | Primary |
Addresses
Primary practice location
5609 N 132ND Dr
Litchfield Park, AZ 85340-8331
Mailing address
5609 N 132ND Dr
Litchfield Park, AZ 85340-8331
Phone (623) 251-9767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7138 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Little Smiles of Surprise | General Practice | Past | Accepting new patients |
| Keith Holm LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- El Mirage, AZ
- NPI 1417441767
-
- General Practice Dentistry
- El Mirage, AZ
- NPI 1134181332
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480982400000",
"number": "1730210980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5609 N 132ND DR",
"city": "LITCHFIELD PARK",
"state": "AZ",
"postal_code": "853408331",
"telephone_number": "623-251-9767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5609 N 132ND DR",
"city": "LITCHFIELD PARK",
"state": "AZ",
"postal_code": "853408331",
"telephone_number": "623-251-9767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLM",
"first_name": "KEITH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2016-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D7138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Litchfield Park, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.