Amon Eugene Holt III, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

61063 Issued in KS

Practice address

975 N Mur Len Rd Ste a
Olathe, KS 66062-1803

Phone

(913) 415-2000

Fax

(913) 415-2004

NPI assigned

Sep 11, 2012

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 names 1

• Dr. Trey Holt Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2015 through Apr 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Periodontal Care West LLC

  • Periodontics
  • Olathe, KS
  • NPI 1174215594
  NPD
• Advanced Specialty Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Lawrence, KS
  • NPI 1821194978
  NPD (past)
• Edwards & Wilson Periodontics, PA

  • Periodontics
  • Lawrence, KS
  • NPI 1699884965
  NPD (past)

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1972853562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 N MUR LEN RD STE A",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621803",
            "telephone_number": "913-415-2000",
            "fax_number": "913-415-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 N MUR LEN RD STE A",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621803",
            "telephone_number": "913-415-2000",
            "fax_number": "913-415-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "AMON",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-11",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "KS",
            "license": "61063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TREY",
            "last_name": "HOLT",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lacey Holley, LMFT
• John C Holloway, ARPN
• Holly Homecare LLC
• Aaron G Holmes, LMFT
• Grant Stewart-Todd Holmes, PHARMD
• Brooklynn Rae Holt
• Lydia M Holtmann, PA
• Isaac Holtz, DPT
• Katie B Holtz
• Heather Renee Holzhauser, LCSW

• Periodontics in Olathe, KS
• Providers in Olathe, KS by specialty
• Periodontics in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.