NPIMap

Organization Active NPI

Marsha Jordan Holloway, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Albany, GA
National Provider Identifier
1811046089
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
010688 Issued in GA
Legal business name
MARSHA JORDAN HOLLOWAY, LLC
Practice address
2547 Lafayette Plaza Dr
Albany, GA 31707-2200
Phone
(229) 438-8228
Fax
(229) 438-0543
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Amanda Cooper
Title
Insurance Coordinator
Phone
(229) 386-1616

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 010688 GA Primary

Addresses

Primary practice location

2547 Lafayette Plaza Dr
Albany, GA 31707-2200

Mailing address

2547 Lafayette Plaza Dr
Albany, GA 31707-2200
Phone (229) 438-8228

National Provider Directory

National Provider Directory
Tax ID family
Marsha Jordan Holloway LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2547 Lafayette Plaza Dr
Albany, GA 31707
Phone (229) 438-8228

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811046089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2547 LAFAYETTE PLAZA DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072200",
            "telephone_number": "229-438-8228",
            "fax_number": "229-438-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2547 LAFAYETTE PLAZA DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072200",
            "telephone_number": "229-438-8228",
            "fax_number": "229-438-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHA JORDAN HOLLOWAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "229-386-1616"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "010688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.