John S. Blalock, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN011681 Issued in GA

Practice address

3606 Wheeler Rd.
Augusta, GA 30909

Phone

(706) 481-8811

Fax

(706) 481-8507

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1003862731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 WHEELER RD.",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30909",
            "telephone_number": "706-481-8811",
            "fax_number": "706-481-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3606 WHEELER RD.",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30909",
            "telephone_number": "706-481-8811",
            "fax_number": "706-481-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "JOHN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN011681",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZG1681",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000879095A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Blais
• Michael Blaivas, MD
• Jean-Pierre Blaize, M.D.
• Rashawn M Blakeney, MD
• Julie Blakey
• William Allen Blalock, M.D.
• Amy Renee Blanchard, MD
• Deborah S Blanchard, LPC
• Kaitlyn James Blanchard, MD
• Justinna Bland

• General Practice Dentistry in Augusta, GA
• Providers in Augusta, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.