Provider Demographics
NPI:1740515949
Name:HOLLY, NAEEMAH (DDS)
Entity type:Individual
Prefix:
First Name:NAEEMAH
Middle Name:
Last Name:HOLLY
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 1:6139 WILSON MILLS RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2101
Mailing Address - Country:US
Mailing Address - Phone:216-342-2600
Mailing Address - Fax:216-342-2602
Practice Address - Street 1:6139 WILSON MILLS RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-2101
Practice Address - Country:US
Practice Address - Phone:216-342-2600
Practice Address - Fax:216-342-2602
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0380671223X0400X
OH30.0231421223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics