Nicole Holmes, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D13110 Issued in MN

Practice address

109 Bushaway Rd
Suite 300
Wayzata, MN 55391-1945

Phone

(952) 475-0225

NPI assigned

Jul 25, 2012

Last updated

Jan 10, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 MN

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

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420848000000",
    "number": "1952657124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BUSHAWAY RD",
            "address_2": "SUITE 300",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BUSHAWAY RD",
            "address_2": "SUITE 300",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911945",
            "telephone_number": "952-475-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "NICOLE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2015-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hillcrest of Wayzatta Operations LLC (Hillcrest of Wayzata Rehabilitation and Healthcare Center)
• Barbara Joanne Hilleren, MA, LP
• Harry Mark Hoberman, PH.D.
• Judith Marie Hock
• Erin Holland, AU.D.
• Kathleen Joan Holst, NCTMB
• Home Care Connections, Inc.
• Home Care Speciality LLC
• Kyle M Hood, LMFT
• Gina Hoops

• Dentist in Wayzata, MN
• Providers in Wayzata, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2015; 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.