Sidney Anthony Holleman Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8786 Issued in TX

Practice address

1116 S Henderson St
Fort Worth, TX 76104-4430

Phone

(817) 336-6048

Fax

(817) 334-0621

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1972517126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044430",
            "telephone_number": "817-336-6048",
            "fax_number": "817-334-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044430",
            "telephone_number": "817-336-6048",
            "fax_number": "817-334-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLEMAN",
        "first_name": "SIDNEY",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "8786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID #",
            "identifier": "M473",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Brent Hollander, M.D.
• Ira Neil Hollander, MD
• Makenzie Brooke Hollandsworth, COTA
• Gail Ann Hollar, D.D.S.
• Kendra L Holleman, RMA, CPT
• Marie Antoinette Holliday, D.M.D
• Kimberly Hollie, PTA
• Tara Hollie
• Angel Hollin
• Mark Edward Hollinger

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.