JASON SHOLLY (NPI# 1144715293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144715293 |
| Entity Type | Individual |
| Full Name | JASON SHOLLY |
| Practice Address |
909 Sleater Kinney Rd Se Ste 3 Lacey WA 98503-1103 |
| Mailing Address |
5401 6th Ave Ste 201 Tacoma WA 98406-2618 |
| Practice Telephone | 3604911414 |
| Practice Fax Number | 3606288015 |
| Mailing Telephone | 2537595437 |
| Mailing Fax Number | 2534261836 |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2018-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DE6085544 | WA | Dental Providers |
| Street Address |
909 SLEATER KINNEY RD SE STE 3 |
| City | LACEY |
| State | WA |
| Zip Code | 98503-1103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457838989 | Michele Nordgren Bourque | Psychologist | 4329 Concordia Lane Se, Lacey, WA 98503 | 2018-07-26 |
| 1831638675 | Trevor John Marum | Chiropractor | 3945 8th Ave Se, Lacey, WA 98503 | 2017-02-13 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1144683616 | Millenda Thomas | Registered Nurse | 1233 Firpark Dr. S.e., Lacey, WA 98503 | 2016-04-01 |
| 1609257245 | Erika Charlotte Vonkotzebue | Counselor | 4401 37th Ave. Se #25, Lacey, WA 98503 | 2015-06-09 |
| 1437576196 | Candy Nelson | Registered Nurse | 4410 6th Ave Se, Apt# 115, Lacy, WA 98503 | 2014-03-19 |
| 1134563919 | Alvin Fitzgerald | Pharmacist | 665 Sleater Kinney Rd., S.e, Target Pharmacy #1355, Lacey, WA 98503 | 2013-04-23 |
| 1518200724 | Katherine Mary Marsh | Psychologist | 5191 Corporate Center Court Se, Lacey, WA 98503 | 2013-04-05 |
| 1740530906 | Leanna Marie Mcbroom | Massage Therapist | 1608 Diamond Loop Se, Lacey, WA 98503 | 2012-09-14 |
| 1831445196 | Joyce Emily Christensen Coniff | Counselor | 5706 39th Ave Se., Lacey, WA 98503 | 2012-07-24 |
| Find all providers in zip 98503 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461825 | Jangsu Kiyoshi | Dentist | 3006 Mahogany St Ne, Lacey, WA 98516-5589 | 2020-09-11 |
| 1215584701 | Nisqually Reach Family Dentistry | Dentist | 2521 Marvin Rd Ne Ste G, Lacey, WA 98516-3153 | 2019-08-20 |
| 1386290641 | Mark Douglas Morrison | Dentist | 9321 Martin Way E Ste 101, Lacey, WA 98516-5928 | 2019-08-13 |
| 1952820607 | Luis Gustavo Acosta | Dentist | 5122 Yelm Hwy Se Ste E, Lacey, WA 98503-5037 | 2017-09-13 |
| 1306234166 | Reza Tahernia | Dentist | 8050 Freedon Lane Ne, Suite C, Lacey, WA 98516 | 2015-01-02 |
| 1831520162 | Lacey Dental, LLC | Dentist | 1110 Galaxy Dr Ne, Lacey, WA 98516-4763 | 2013-12-12 |
| 1336589506 | Joshua C Carpenter | Dentist | 3201 Willamette Dr Ne, Suite A, Lacey, WA 98516-1376 | 2013-07-02 |
| 1396973418 | Tyler R Burningham | Dentist | 8857 Windham Ct Ne, Lacey, WA 98516-3884 | 2009-06-26 |
| 1780847103 | Scott John Neuhaus | Dentist | 3925 Pacific Ave Se, Lacey, WA 98503-1108 | 2008-07-07 |
| 1588859425 | Family Dentistry At Hawks Prairie | Dentist | 9321 Martin Way E., Suite 101, Lacey, WA 98516 | 2007-09-13 |
| Find all providers in LACEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.