Active NPI
Tessa Holmes
- Pediatric Dentistry
- Spokane, WA
National Provider Identifier
1942863196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DE60970889
- Practice address
- 611 E 31St Ave
Spokane, WA 99203-3101 - Phone
- (360) 904-2658
- NPI assigned
- Apr 15, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Dentistry | 1223P0221X | DE60970889 | WA | Primary |
Addresses
Primary practice location
611 E 31St Ave
Spokane, WA 99203-3101
Mailing address
611 E 31St Ave
Spokane, WA 99203-3101
Phone (509) 315-8500
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 |
|---|---|---|---|
| DE60970889 | WA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1942863196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 E 31ST AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992033101",
"telephone_number": "509-315-8500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 E 31ST AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992033101",
"telephone_number": "360-904-2658"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "TESSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-15",
"last_updated": "2022-02-02",
"certification_date": "2022-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WA",
"license": "DE60970889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.