BRENT L HOLMAN DDS PC (NPI# 1265595995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265595995 |
| Entity Type | Organization |
| Organization Name | BRENT L HOLMAN DDS PC |
| Practice Address |
2538 University Dr S Suite A Fargo ND 58103-5737 |
| Practice Telephone | 7012321148 |
| Practice Fax Number | 7012328907 |
| Mailing Telephone | 7012321148 |
| Mailing Fax Number | 7012328907 |
| Enumeration Date | 2006-12-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BRENT L HOLMAN (PRESIDENT) |
| Authorized Official Telephone | 7012321148 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
1587 | ND | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | ND BLUE CROSS BLUE SHIELD | 26296 | 01 |
| MN | DELTA DENTAL | 330 | 01 |
| ND | 40633 | 05 | |
| MN | BLUE CROSS BLUE SHIELD | 91799110 | 01 |
| Street Address |
2538 UNIVERSITY DR S SUITE A |
| City | FARGO |
| State | ND |
| Zip Code | 58103-5737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669554341 | Jon D Anderson | Dentist | 2538 University Dr S, Ste B, Fargo, ND 58103-5737 | 2006-10-20 |
| 1568873032 | Carl A. Trout, Dds, PC | Clinic/Center | 2538 University Dr S, Suite A, Fargo, ND 58103-5714 | 2014-05-18 |
| 1033398458 | Carl A Trout | Dentist | 2538 University Dr S, Suite A, Fargo, ND 58103-5714 | 2007-11-01 |
| 1528121258 | Brent L Holman | Dentist | 2538 University Dr S, Suite A, Fargo, ND 58103-5737 | 2006-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659622173 | Melanie Lynn Hageman | Dentist | 3142 49th St S, Fargo, ND 58104-4450 | 2012-09-24 |
| 1992891428 | Chad Hoge | Dentist | 4265 45th St S, Suite 202, Fargo, ND 58104-4309 | 2006-10-04 |
| 1619084084 | Pediatric Dentistry Ltd | Dentist | 1205 16th Ave South, Fargo, ND 58103 | 2006-08-23 |
| 1992977680 | William A Hunter | Dentist | 1205 16th Ave South, Fargo, ND 58103 | 2008-04-02 |
| 1033398458 | Carl A Trout | Dentist | 2538 University Dr S, Suite A, Fargo, ND 58103-5714 | 2007-11-01 |
| 1528121258 | Brent L Holman | Dentist | 2538 University Dr S, Suite A, Fargo, ND 58103-5737 | 2006-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023271020 | Lawrence E Steininger | Dentist | 1929 N Washington St Ste Op, Bismarck, ND 58501-1616 | 2008-07-09 |
| 1821152869 | Donald Michael Goebel | Dentist | 407 E Avenue C, Bismarck, ND 58501-3942 | 2006-12-21 |
| 1649215732 | Lance Robert Behm | Dentist | 2615 Elk Dr Ste 1, Minot, ND 58701 | 2006-06-20 |
| 1053979013 | A To Z Pediatric Dentistry, PC | Dentist | 1929 N Washington St Ste Op, Bismarck, ND 58501-1616 | 2019-06-04 |
| 1235695958 | Big Bear Dentistry | Dentist | 2615 Elk Dr Ste 1, Minot, ND 58701-1200 | 2019-02-18 |
| 1184197931 | Doughboy Pediatric Dental Group | Dentist | 2615 Elk Dr Ste 1, Minot, ND 58701-1200 | 2019-01-04 |
| 1164910006 | Lisa Diane Kulig | Dentist | 2615 Elk Dr Ste 1, Minot, ND 58701-1200 | 2018-04-26 |
| 1295021988 | Drew Goebel | Dentist | 407 E Avenue C, Bismarck, ND 58501-3942 | 2011-06-22 |
| 1215107248 | D. Michael Goebel D.d.s., PC | Dentist | 407 E Avenue C, Bismarck, ND 58501-3942 | 2008-03-05 |
| 1851582100 | Dakota Kids Dentistry | Dentist | 2615 Elk Dr Ste 1, Minot, ND 58701-1200 | 2007-08-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.