Rosario I. Holland DDS Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

57147 Issued in CA

Legal business name

ROSARIO I. HOLLAND DDS INC.

Doing business as

Lifetime Smile Dental

Practice address

15418 Hawthorne Blvd
Ste a
Lawndale, CA 90260-3828

Phone

(310) 679-0697

NPI assigned

Jun 27, 2012

Last updated

Jun 27, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rosario I Holland, DDSNPI 1295984276

Title

President

Phone

(310) 679-0697

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lifetime Smile Dental Doing business as

Locations

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.

• Rosario I Holland, DDS

  • Dentist
  • Lawndale, CA
  • NPI 1295984276
  NPD Authorized official

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1750645420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15418 HAWTHORNE BLVD",
            "address_2": "STE A",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902603828",
            "telephone_number": "310-679-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15418 HAWTHORNE BLVD",
            "address_2": "STE A",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902603828",
            "telephone_number": "310-679-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSARIO I. HOLLAND DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "ROSARIO",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-679-0697",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B57147",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Smile Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Lawndale, CA
• Providers in Lawndale, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.