Active NPI
Thomas Anthony Holt, DDS
- General Practice Dentistry
- Maple Valley, WA
National Provider Identifier
1225272719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE00010295
- Practice address
- 27016 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038 - Phone
- (425) 413-8525
- Fax
- (425) 413-8599
- NPI assigned
- Apr 28, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE00010295 | WA | Primary |
Addresses
Primary practice location
27016 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038
Mailing address
27016 Maple Valley Black Diamond Rd SE
Maple Valley Family Dental Care
Maple Valley, WA 98038
Phone (425) 413-8525
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
| License | State | Type | Specialty |
|---|---|---|---|
| DE00010295 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240876800000",
"number": "1225272719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27016 MAPLE VALLEY BLACK DIAMOND RD SE",
"address_2": "MAPLE VALLEY FAMILY DENTAL CARE",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "98038",
"telephone_number": "425-413-8525",
"fax_number": "425-413-8599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27016 MAPLE VALLEY BLACK DIAMOND RD SE",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "98038",
"telephone_number": "425-413-8525",
"fax_number": "425-413-8599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "THOMAS",
"middle_name": "ANTHONY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-28",
"last_updated": "2009-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE00010295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maple Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.