Provider Demographics
NPI:1700964244
Name:HOLMES, DENNIS M (DMD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:M
Last Name:HOLMES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 VIRGINIA WAY
Mailing Address - Street 2:SUITE C-13
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027
Mailing Address - Country:US
Mailing Address - Phone:615-371-8888
Mailing Address - Fax:615-371-8894
Practice Address - Street 1:5120 VIRGINIA WAY
Practice Address - Street 2:SUITE C-13
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027
Practice Address - Country:US
Practice Address - Phone:615-371-8888
Practice Address - Fax:615-371-8894
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN108771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL33486OtherBCBS ID #