Holly Lewis, DMD, MS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

0401411085 Issued in VA

Practice address

11934 W Broad St Ste 120
Henrico, VA 23233-1100

Phone

(804) 746-7382

Fax

(804) 746-3025

NPI assigned

Jul 11, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sparkle Pediatric Dentistry

  • Pediatric Dentistry
  • Henrico, VA
  • NPI 1821535444
  NPD Authorized official
• Pediatric Dentistry of Virginia, PLLC

  • Pediatric Dentistry
  • Mechanicsville, VA
  • NPI 1295964955
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1073548947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8203 CENTER PATH LN",
            "address_2": "SUITE A",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231164060",
            "telephone_number": "804-746-7382",
            "fax_number": "804-746-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11934 W BROAD ST STE 120",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232331100",
            "telephone_number": "804-746-7382",
            "fax_number": "804-746-3025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8203 Center Path Ln # A",
            "address_purpose": "LOCATION",
            "city": "Mechanicsville",
            "state": "VA",
            "postal_code": "231164060",
            "country_code": "US",
            "telephone_number": "804-746-7382",
            "fax_number": "804-746-3025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "HOLLY",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401411085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INS.",
            "identifier": "1777225",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "184570",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9179294",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Lent
• Carine Leslie, MS
• Level Up Counseling, LLC
• Level Up Supportive Services, LLC.
• Ashley Monee Lewis, QMHP-A
• Jenna Lewis, M.S., BCBA, LBA
• Katherine C Lewis, BCBA
• Leigh Leffingwell Lewis, FNP-C
• Sharday Lewis, OTA/L
• Sheena Lewis, RN

• Pediatric Dentistry in Henrico, VA
• Providers in Henrico, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.