Active NPI
Teresa Anne Holzer, DDS
- General Practice Dentistry
- Mukilteo, WA
National Provider Identifier
1922116706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE00008145
- Practice address
- 12199 Village Center Place
Suite 204
Mukilteo, WA 98275 - Phone
- (425) 349-5600
- Fax
- (425) 349-5601
- NPI assigned
- Aug 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1774 | NM | |
| Dentist | 122300000X | D7431 | OR | |
| General Practice Dentistry | 1223G0001X | DE00008145 | WA | Primary |
Addresses
Primary practice location
12199 Village Center Place
Suite 204
Mukilteo, WA 98275
Mailing address
321 High School Rd NE Suite D3
PMB 137
Bainbridge Island, WA 98110
Phone (425) 349-5600
Other names 1
- Teresa A Holzer
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 |
|---|---|---|---|
| 1774 | NM | MD | Dentist |
| D7431 | OR | MD | Dentist |
| DE00008145 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aaron Van Wong DDS PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Mukilteo, WA
- NPI 1669320651
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1922116706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 HIGH SCHOOL RD NE SUITE D3",
"address_2": "PMB 137",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "98110",
"telephone_number": "425-349-5600",
"fax_number": "425-349-5601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12199 VILLAGE CENTER PLACE",
"address_2": "SUITE 204",
"city": "MUKILTEO",
"state": "WA",
"postal_code": "98275",
"telephone_number": "425-349-5600",
"fax_number": "425-349-5601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLZER",
"first_name": "TERESA",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "1774",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D7431",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE00008145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TERESA",
"last_name": "HOLZER",
"middle_name": "A",
"credential": "DDS PC",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Mukilteo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.