Jeremiah Wilson Holt, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12330 Issued in TN

Practice address

4957 Swinyar Dr Ste 107
Ooltewah, TN 37363-2205

Phone

(423) 396-3154

NPI assigned

Jun 29, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Cedar Valley Dental Arts, PLLC

  • Dental Clinic/Center
  • Ooltewah, TN
  • NPI 1740046234
  NPD Authorized official
• David H. Otis, D.D.S.

  • Dental Clinic/Center
  • Ooltewah, TN
  • NPI 1881151991
  NPD (past)
• Topsham Dental Arts

  • General Practice Dentistry
  • Topsham, ME
  • NPI 1669657136
  NPD (past)

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1669104451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4957 SWINYAR DR STE 107",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373632205",
            "telephone_number": "423-396-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4957 SWINYAR DR STE 107",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373632205",
            "telephone_number": "423-396-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "JEREMIAH",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "12330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Philip Henri Hopkins Jr., DR. OF PHARMACY
• Stephanie Huskins
• Lorri Lynn Ilchuk, PT

• General Practice Dentistry in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.