Stacie Lynn Holt, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22171 Issued in TX

Practice address

1939 Lawrence Rd
Kemah, TX 77565-3122

Phone

(281) 538-9300

Fax

(281) 538-9031

NPI assigned

Jul 26, 2006

Last updated

Oct 8, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Stacie Lynn Devault Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• We Create Your Perfect Smile PC

  dba Your Perfect Smile

  • General Practice Dentistry
  • Kemah, TX
  • NPI 1700260718
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1437173390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1939 LAWRENCE RD",
            "city": "KEMAH",
            "state": "TX",
            "postal_code": "775653122",
            "telephone_number": "281-538-9300",
            "fax_number": "281-538-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 LAWRENCE RD",
            "city": "KEMAH",
            "state": "TX",
            "postal_code": "775653122",
            "telephone_number": "281-538-9300",
            "fax_number": "281-538-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "STACIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22171",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22158",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIE",
            "last_name": "DEVAULT",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gulf Coast DME
• Hands With Heart Home Care
• Alyssa Anne Hanzon, MFT INTERN
• Healing H. a. D. C., Inc (Caring Hearts Adult Activity Center)
• Healthtrust
• Hometown Health and Wellness, PLLC
• Terri Hubbard, LCDC
• Jeliea Maia Jardine, LMSW
• Koralina Jimenez
• Karyann Keaton

• General Practice Dentistry in Kemah, TX
• Providers in Kemah, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.