DR. JACK ROBERT HOLT


Address: 1213 Coffee Rd, Suite M, Modesto, CA 95355-4229
Phone: 2095215959

DR. JACK ROBERT HOLT (NPI# 1629293618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629293618
Entity Type Individual
Full Name DR. JACK ROBERT HOLT
Credential DDS
Practice Address 1213 Coffee Rd
Suite M
Modesto
CA 95355-4229
Practice Telephone 2095215959
Practice Fax Number 2095211082
Mailing Telephone 2095215959
Mailing Fax Number 2095211082
Enumeration Date 2007-04-16
Last Update Date 2013-05-09
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 122300000X Dentist 16922 CA Dental Providers

Other Providers JACK HOLT

NPI Name Taxonomy Address Enumeration
1104168624 Jack L Holt Pharmacist 916 W Evergreen Blvd, Vancouver, WA 98660-3035 2013-03-22

Office Location

Street Address 1213 COFFEE RD
SUITE M
City MODESTO
State CA
Zip Code 95355-4229

Providers in the same location

NPI Name Taxonomy Address Enumeration
1023017225 David Aaron Woodruff Dentist 1213 Coffee Rd, Suite K, Modesto, CA 95355-4229 2005-07-19
1548646839 Edwin Y. Josephs Dds, Inc Dentist 1213 Coffee Rd, Ste. J, Modesto, CA 95355-4229 2015-08-10
1427391044 Amanda Pearl Farley Dentist 1213 Coffee Rd, Suite C, Modesto, CA 95355-4229 2013-04-02
1366713018 Betty Kilpatrick Hansen Marriage & Family Therapist 1213 Coffee Rd, Suite P, Modesto, CA 95355-4229 2012-01-25
1225320211 Kelly Gaines Family Medicine 1213 Coffee Rd, Modesto, CA 95355-4229 2011-05-09
1568654986 Brian Kelly Hutto Dentist 1213 Coffee Rd, Suite D, Modesto, CA 95355-4229 2007-08-10
1821110586 Meridith Mccurdy-yeoman Physician Assistant 1213 Coffee Rd, Modesto, CA 95355-4229 2007-04-04
1598886178 George J Di Cristina Dentist 1213 Coffee Rd, Suite J, Modesto, CA 95355-4229 2007-04-02
1073639043 Sylvia Diane Victor Marriage & Family Therapist 1213 Coffee Rd, Suite P, Modesto, CA 95355-4229 2007-03-22
1588704951 Lance Bautista Dentist 1213 Coffee Rd, Modesto, CA 95355-4229 2007-02-07
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982211793 I To I LLC Optometrist 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 2020-09-25
1205443116 Altwal and Shelat Dds Inc Dentist 1317 Oakdale Road, Suite 310, Modesto, CA 95355 2020-09-24
1184255911 Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation Clinic/Center 3401 Oakdale Road, Suite 505, Modesto, CA 95355 2020-01-30
1487133856 Natalie Vargas Behavior Technician 1317 Oakdale Road Suite 610, Modesto, CA 95355 2018-08-07
1871079152 Jill H Fusia Dietitian, Registered 1404 Cordero Court, Modesto, CA 95355 2018-07-19
1043727514 Emily Lauren Schaefer Behavioral Analyst 3425 Coffee Rd Ste C2, Modesto, CA 95355 2018-01-05
1376083691 Hari Gnanasekeram, PC Technician, Cardiology 1303 Mable Avenu, Modesto, CA 95355 2017-03-06
1598139891 Encompass Health Rehabilitation Hospital of Modesto, LLC Rehabilitation Hospital 1303 Mable Avenue, Modesto, CA 95355 2015-11-24
1013387844 Diana Faith Kigenyi Social Worker 1225 Oakdale Road, Modesto, CA 95355 2015-10-06
1437530672 Tzu Yi Wei Acupuncturist 2209 Coffee Road, Suite A, Modesto, CA 95355 2015-06-12
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Taxonomy Information

Taxonomy Code 122300000X
Grouping Dental Providers
Classification Dentist

Taxonomy Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1205443116 Altwal and Shelat Dds Inc Dentist 1317 Oakdale Road, Suite 310, Modesto, CA 95355 2020-09-24
1306310933 Western Dental Services, Inc. Dentist 2605 Coffee Rd Ste 200, Modesto, CA 95355-2064 2019-01-16
1205320223 Western Dental Services, Inc. Dentist 2900 Standiford Ave Ste 2, Modesto, CA 95350-6575 2018-06-22
1215438130 Lopez Dental Corporation Dentist 3601 Pelandale Ave Ste D-1, Modesto, CA 95356-9808 2018-02-26
1053820522 Pannu and Henne Dental Corp. Dentist 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 2017-09-27
1013457118 Kaur and Borrero Dds Dental Corp Dentist 1801 Tully Rd Ste A1, Modesto, CA 95350-2937 2017-03-08
1821461104 Michael Lopez Dental Corporation Dentist 2103 Mchenry Avenue, Suite C, Modesto, CA 95350 2015-11-09
1760899884 David Merrill Paxman Dentist 400 E Orangeburg Ave Ste 4, Modesto, CA 95350-5365 2014-07-21
1083021323 Maninder Kaur Dhillon Dentist 1912 Standiford Ave Ste 1, Modesto, CA 95350-6507 2014-07-18
1043621618 Nicholas Poblete Dentist 1316 Coffee Rd., Bldg. C, Modesto, CA 95355 2014-05-16
Find all providers in MODESTO

Competitor

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City MODESTO
Zip Code 95355

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Dataset Information

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.

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