DR. RICHARD FREDERICK JOHN HOLTZEN III (NPI# 1588608616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588608616 |
| Entity Type | Individual |
| Full Name | DR. RICHARD FREDERICK JOHN HOLTZEN III |
| Credential | D.M.D. |
| Practice Address |
805 S Reserve St Missoula MT 59801-2104 |
| Practice Telephone | 4063816845 |
| Mailing Telephone | 4063816845 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2016-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2431 | MT | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
101008 | CA | Dental Providers |
| Y | 174400000X | Specialist | 3332-S228 | NV | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 002202076 | 05 |
| Street Address |
805 S RESERVE ST |
| City | MISSOULA |
| State | MT |
| Zip Code | 59801-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346642998 | Surgical Sleep Solutions Pllc | Oral & Maxillofacial Surgery | 805 S Reserve St, Missoula, MT 59801-2104 | 2014-09-25 |
| 1407116338 | Facial Plastic and Reconstructive Surgery Montana PC | Clinic/Center | 805 S Reserve St, Missoula, MT 59801-2104 | 2012-05-25 |
| 1174661011 | Lisa Lya Pacheco | Neuromusculoskeletal Medicine & OMM | 805 S Reserve St, Missoula, MT 59801 | 2007-02-02 |
| 1134286883 | Facial Plastic & Reconstructive Surgery Montana PC | Clinic/Center | 805 S Reserve St, Missoula, MT 59801-2104 | 2007-01-02 |
| 1689745804 | Clark O Taylor | Oral & Maxillofacial Surgery | 805 S Reserve St, Missoula, MT 59801-2104 | 2006-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
| 1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
| 1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
| 1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
| 1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
| 1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
| 1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
| Find all providers in zip 59801 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215549829 | Jolyn Ortega | Specialist | 2539 Granary Rd, Missoula, MT 59808-8748 | 2020-08-17 |
| 1629609219 | Montana Yoga Therapy | Specialist | 2825 Stockyard Rd Ste H3, Missoula, MT 59808-1507 | 2020-02-01 |
| 1841775772 | Elli Marie Matkin | Specialist | 210 N Higgins Ave Ste 220, Missoula, MT 59802-4443 | 2018-09-26 |
| 1407361736 | Mothers' Milk Bank of Montana | Specialist | 2825 Stockyard Rd Ste C1, Missoula, MT 59808-1502 | 2017-12-08 |
| 1952700213 | Barbara Ann Balko | Specialist | 4825 Lower Miller Creek Rd, Missoula, MT 59803-9718 | 2014-08-21 |
| 1831421296 | Melissa Wardlow | Specialist | 211 N Higgins Ave Ste 403, Missoula, MT 59802-4488 | 2010-02-09 |
| 1912132481 | Michelle Marlene Mcclain | Specialist | 2409 Dearborn Ave Ste I, Missoula, MT 59801-7586 | 2009-05-27 |
| 1194964346 | Erin E Williams | Specialist | 515 S Reserve St Ste 5, Missoula, MT 59801-2125 | 2009-02-11 |
| 1225280001 | Bradford Walker Mcmullin | Specialist | 2525 Humble Rd, Missoula, MT 59804-6149 | 2008-10-13 |
| 1912127770 | Gwen Farnsworth | Specialist | 30 Fort Missoula # 10, Missoula, MT 59804-7203 | 2007-04-26 |
| Find all providers in MISSOULA | ||||
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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.