Kimberly Marie Hollywood, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DI02508000 Issued in NJ

Practice address

500 Franklin Ave
Nutley, NJ 07110-1720

Phone

(973) 667-5507

NPI assigned

Mar 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hollywood Pediatric Dentistry

  • Pediatric Dentistry
  • Nutley, NJ
  • NPI 1942797311
  NPD (past) Authorized official

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1821364118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101720",
            "telephone_number": "973-667-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FRANKLIN AVE",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101720",
            "telephone_number": "973-667-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLYWOOD",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-30",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02508000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Herman, LSW
• High Street Rehab, LLC
• Patrick Hines, MD
• Holistic Counseling Center
• Hollywood Pediatric Dentistry
• Megan Grace Holt, PA
• Home We Go LLC
• Pranali Hoyle, PH.D.
• Danielle Denise Hungerbuhler, M.S., CCC-SLP
• Ahmed Yosry Ibrahim

• Pediatric Dentistry in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.