Individual provider Active NPI

Michelle R Holmes, DDS

  • Dentist
  • Leland, NC
National Provider Identifier
1215040720
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8744 Issued in NC
Practice address
117H Village Rd NE
Leland, NC 28451-7413
Phone
(910) 371-5664
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 150586 NC
General Practice Dentistry 1223G0001X 019-026310 IL
Dentist 122300000X 8744 NC Primary

Addresses

Primary practice location

117H Village Rd NE
Leland, NC 28451-7413

Mailing address

6211 Terrapin CT
Wilmington, NC 28409-2045
Phone (910) 409-2307

Other identifiers 1

IdentifierTypeStateIssuer
566000329OtherNCOTHER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8744NCMDMental Health Counselor
150586NCMDDentist
019-026310ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1215040720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 TERRAPIN CT",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284092045",
            "telephone_number": "910-409-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117H VILLAGE RD NE",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284517413",
            "telephone_number": "910-371-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "150586",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-026310",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "566000329",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2011; 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.