Lan-Tu Dang Holem, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

014975 Issued in MO

Practice address

340 Kelley Pkwy
Mexico, MO 65265-3811

Phone

(573) 582-1234

Fax

(573) 582-1212

NPI assigned

Sep 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lantu.holem.p1@direct.arthurcenter.nextgenshare.com

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• East Central Missouri Behavioral Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Montgomery City, MO
  • NPI 1376164699

  Corporate Officer

  CMS ownership
• East Central Missouri Behavioral Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fulton, MO
  • NPI 1174008023

  Corporate Director

  CMS ownership

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.

• East Central Missouri Behavioral Health Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mexico, MO
  • NPI 1144293549
  Medicare reassignment NPD
• East Central Missouri Behavioral Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Montgomery City, MO
  • NPI 1376164699
  NPD

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1902892235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 KELLEY PKWY",
            "city": "MEXICO",
            "state": "MO",
            "postal_code": "652653811",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLEM",
        "first_name": "LAN-TU",
        "middle_name": "DANG",
        "name_prefix": "Ms.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "014975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403030430",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER IDENTIF",
            "identifier": "1902892235",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regina Marie Hill, FNP-BC
• Laura Jean Hillard, PT
• Alex Hobbs, DPT
• Raychel Hodgson, LPC
• Michelle Hoeing, RDN, LD
• Laura M Hoover, LCSW
• Marlene A Howser, LPC
• Georgetta Jean Hull, LCSW
• Image Chiropractic PC
• International Eyecare Center, Inc

• General Practice Dentistry in Mexico, MO
• Providers in Mexico, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.