Victoria Tucker Otterholt, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4963 Issued in WA

Practice address

104 N 15TH St
Mount Vernon, WA 98273-3405

Phone

(360) 424-9045

NPI assigned

May 24, 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

Medicare fee-for-service enrollment

Enrolled in WA

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

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780639740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 RIDGE WAY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982739452",
            "telephone_number": "360-424-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N 15TH ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982733405",
            "telephone_number": "360-424-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTERHOLT",
        "first_name": "VICTORIA",
        "middle_name": "TUCKER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "4963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Osborne, MSW, LICSW, SUDP
• Victoria Lynn Osborne, PHARM-D
• Sharon A. Osea, MD
• Alina Yakivna Ostapchuk, ARNP
• Dana Eric Otterholt, D.D.S.
• Otterson Counseling PS
• Elizabeth Ann Otterson, MSW, LICSW
• Joseph Ottolenghi
• Todd R Ouellette, ARNP
• Deborah Suzanne Owens, ARNP

• General Practice Dentistry in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.