Holladay Dental Studio PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

HOLLADAY DENTAL STUDIO PLLC

Practice address

4888 S Highland Dr
Holladay, UT 84117-6007

Phone

(801) 277-9213

Fax

(385) 770-7196

NPI assigned

Sep 3, 2020

Organization subpart

No

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

Authorized official

Name

Andrew Ericksen, DDS

Title

Owner

Phone

(801) 277-9213

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1821602137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4888 S HIGHLAND DR",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841176007",
            "telephone_number": "801-277-9213",
            "fax_number": "385-770-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4888 S HIGHLAND DR",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841176007",
            "telephone_number": "801-277-9213",
            "fax_number": "385-770-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLADAY DENTAL STUDIO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "ERICKSEN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-277-9213",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie Lee Hippolite Wright, MSW, PHD
• Conor Hodgson, PA-C
• Marina Hoggan, MS
• Holladay Center Dental
• Holladay Dental Studio PLLC
• Holladay Home Assisted Living LLC (Holladay Home For The Elderly)
• Holladay Home for the Elderly
• Holladay Modern Dentistry, LLP (Holladay Modern Dentistry)
• Holladay Opco LLC (Spring Gardens Holladay)
• Holladay Pharmacy Inc

• Oral and Maxillofacial Surgery (Dentist) in Holladay, UT
• Providers in Holladay, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.