Doctor profile · Federal record

Dr. Shalise Holt, DDS, MS

Orthodontics and Dentofacial Orthopedic Dentist · Loves Park, IL

  • NPI 1164904272
  • 8 yrs on file
  • Female
  • Group practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
4001 N Mulford RD
Loves Park, IL 611116949
(815) 877-6453

Credentials & registration

NPPES · NUCC
NPI registered
September 2018 — 8 yrs on file
Specialty taxonomy
1223X0400X — NUCC code
State license (1)
Illinois #021.002884

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1164904272. Last verified May 11, 2026.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$38
Transactions
2
Manufacturers
2
Payer (manufacturer) Industry Txns Amount
GC America Inc. 1 $18.83
LIGHTFORCE ORTHODONTICS, INC. 1 $18.67

By nature of payment

Food and Beverage
$38

Frequently asked questions

Auto-generated from federal data
What is Dr. Shalise Holt's medical specialty?
Dr. Shalise Holt practices Orthodontics and Dentofacial Orthopedic Dentist in Loves Park, IL.
Where does Dr. Shalise Holt practice?
Dr. Shalise Holt practices at 4001 N Mulford RD, Loves Park, IL 611116949. Office phone: 8158776453.
What is Dr. Shalise Holt's NPI?
Dr. Shalise Holt's National Provider Identifier (NPI) is 1164904272, issued by NPPES.