Mark Andrew Holman, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

60917 Issued in KS

Practice address

4601 W 109TH St
Suite 250
Overland Park, KS 66211-1318

Phone

(913) 438-3636

Fax

(913) 498-0935

NPI assigned

Apr 20, 2007

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

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

State licenses

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1972720613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST",
            "address_2": "SUITE 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111318",
            "telephone_number": "913-438-3636",
            "fax_number": "913-498-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 W 109TH ST",
            "address_2": "SUITE 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111318",
            "telephone_number": "913-438-3636",
            "fax_number": "913-498-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "KS",
            "license": "60917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle A Holloway, NP
• Jacqueline Holloway
• Scott A Hollrah, M.D.
• Chandler Holman, PT, DPT
• Kaitlyn Holman
• Bianca Yoshima Holmes
• Casey Renee Holmes
• Emily Holmes
• Jessie Holmes, M.D.
• Lauren Holmes, OTR

• Endodontics in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Endodontics in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.