MEDICARE: CASEY HOLMES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	13809	NC

General Provider Information

NPI Number	:	1194663112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY HOLMES

Provider Business Mailing Address
First Line	:	9500 ANNAPOLIS RD STE A7
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-2061
Country	:	US
Telephone Number	:	301-577-7107
Fax Number	:

Provider Business Practice Location Address
First Line	:	6238 ARDENNES STREET BUILDING #C-6238
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-432-8170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ CASEY HOLMES ” Practice Location

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