NPIMap

Organization Active NPI

Lee F. Hollister,DDS Jon E. Hollisterdds Dental Corporation

  • General Practice Dentistry
  • San Luis Obispo, CA
National Provider Identifier
1962609529
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28328 Issued in CA
Legal business name
LEE F. HOLLISTER,DDS JON E. HOLLISTERDDS DENTAL CORPORATION
Practice address
1042 Pacific St
Suite B
San Luis Obispo, CA 93401-3621
Phone
(805) 543-6963
Fax
(805) 543-8656
NPI assigned
Jun 28, 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
Jon E. Hollister, DDSNPI 1528102407
Title
Dentist Owner
Phone
(805) 543-6963

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 28328 CA Primary

Addresses

Primary practice location

1042 Pacific St
Suite B
San Luis Obispo, CA 93401-3621

Mailing address

1042 Pacific St
Suite B
San Luis Obispo, CA 93401-3621
Phone (805) 543-6963

National Provider Directory

National Provider Directory

Locations

1042 Pacific St
Ste B
San Luis Obispo, CA 93401
Phone (805) 263-4787

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962609529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 PACIFIC ST",
            "address_2": "SUITE B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013621",
            "telephone_number": "805-543-6963",
            "fax_number": "805-543-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 PACIFIC ST",
            "address_2": "SUITE B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013621",
            "telephone_number": "805-543-6963",
            "fax_number": "805-543-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE F. HOLLISTER,DDS JON E. HOLLISTERDDS DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLLISTER",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "805-543-6963",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

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.