Healthcare Provider Details

I. General information

NPI: 1861832834
Provider Name (Legal Business Name): CODY WARNER WINTERHOLLER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2013
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2807 S STONE ST STE 201
SPOKANE WA
99223-4904
US

IV. Provider business mailing address

2807 S STONE ST STE 201
SPOKANE WA
99223-4904
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-6261
  • Fax:
Mailing address:
  • Phone: 509-838-6261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number7111
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number09076
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number9555
License Number StateMT
# 4
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE61318741
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: