John Andrew Holland, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D7112 Issued in OR

Practice address

10102 NE Glisan St
Portland, OR 97220-4456

Phone

(503) 257-5959

NPI assigned

Aug 19, 2006

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in OR

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

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1306192455
  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972618346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2092 NORTHTREE DR NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973031974",
            "telephone_number": "503-393-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10102 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204456",
            "telephone_number": "503-257-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D7112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORAL SURGERY",
            "identifier": "1223S0112X",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Ray Holland, MD
• Devora Moon Holland, LCSW
• Haley Anne Holland
• Jeffrey Clay Holland
• Jennifer L Holland, PMHNP
• John Michael Holland, MD
• John William Holland, DDS
• Keith Holland, LLMSW
• Kristen Elizabeth Holland
• Meghan Blair Holland, CNM

• Oral and Maxillofacial Surgery (Dentist) in Portland, OR
• Providers in Portland, OR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.