Dr. Russell Lane Holderness, DDS
Dentist in Venice, FL. Individual provider (NPI-1).
NPI number1679808166
StatusActive
Last updated in NPPESApr 10, 2026
Details
- NPI
- 1679808166
- Entity type
- Individual (NPI-1)
- Name
- Dr. Russell Lane Holderness
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 16, 2009
- Certification date
- Apr 10, 2026
- Last updated
- Apr 10, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - DENTIST
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | DN31046 | FL | Yes |
Practice location
1150 Jacaranda BlvdVenice, FL 34292
Phone 703-966-4674
Mailing address
522 Pine Ranch East RdOsprey, FL 34229-8973
Phone 703-966-4674
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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