IndividualActive
Dementre Holmes, OPTICIAN
NPI 1821419979 · Optician · Glendale, AZ
Provider details
- NPI number
- 1821419979
- Entity type
- Individual
- Primary specialty
- OpticianEye and Vision Services Providers
- Credential
- OPTICIAN
- Sex
- Male
- Sole proprietor
- Yes
- License
- 2447I (AZ)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
11409 N 58th Dr
Glendale, AZ 85304-3312
Phone: (480) 577-7096
Fax: (800) 869-4964
Approximate (ZIP-level) locationGet directions
Mailing address
11409 N 58th Dr
Glendale, AZ 85304-3312
Additional practice locations (1)
- 600 W Dunlap AvePhoenix, AZ 85021-3527Phone: (480) 577-7096Fax: (800) 869-4964
Registry dates
- Enumerated
- 2013-12-16
- Last updated
- 2021-05-03
- Certified
- 2021-05-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.