Bruce E Holes, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10,036 Issued in GA

Practice address

22 W Robert Toombs Ave
Washington, GA 30673-1662

Phone

(706) 678-4300

Fax

(706) 678-1750

NPI assigned

Sep 13, 2005

Last updated

May 3, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1831184100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 W ROBERT TOOMBS AVE",
            "city": "WASHINGTON",
            "state": "GA",
            "postal_code": "306732107",
            "telephone_number": "706-678-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W ROBERT TOOMBS AVE",
            "city": "WASHINGTON",
            "state": "GA",
            "postal_code": "306731662",
            "telephone_number": "706-678-4300",
            "fax_number": "706-678-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLES",
        "first_name": "BRUCE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10,036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00303025A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jeri L Hucke, RN
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• General Practice Dentistry in Washington, GA
• Providers in Washington, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.