Provider Demographics
NPI:1598996720
Name:HOLNESS, EIJAH S (DDS)
Entity Type:Individual
Prefix:DR
First Name:EIJAH
Middle Name:S
Last Name:HOLNESS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9199 REISTERSTOWN RD
Mailing Address - Street 2:SUITE 203A
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4520
Mailing Address - Country:US
Mailing Address - Phone:410-356-8571
Mailing Address - Fax:410-356-8574
Practice Address - Street 1:9199 REISTERSTOWN RD
Practice Address - Street 2:SUITE 203A
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4520
Practice Address - Country:US
Practice Address - Phone:410-356-8571
Practice Address - Fax:410-356-8574
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD146071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice