MEDICARE: DR. JONATHAN HOLLOWAY DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D.007306-C1	AL

General Provider Information

NPI Number	:	1346194834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN HOLLOWAY DMD

Provider Business Mailing Address
First Line	:	300 N AIRPORT RD STE 1
Second Line	:
City	:	JASPER
State	:	AL
Zip	:	35504-2516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 N AIRPORT RD STE 1
Second Line	:
City	:	JASPER
State	:	AL
Zip	:	35504-2516
Country	:	US
Telephone Number	:	205-221-6700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	02/23/2026

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