Blake Herbison DDS PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

DE00011059 Issued in WA

Legal business name

BLAKE HERBISON DDS PLLC

Practice address

18520 101St Ave NE
Bothell, WA 98011-3804

Phone

(425) 486-2727

NPI assigned

Dec 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Blake Herbison, D.D.S.NPI 1689996340

Title

Member

Phone

(425) 486-2727

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blake Herbison

  • General Practice Dentistry
  • Bothell, WA
  • NPI 1689996340
  NPD (past) Authorized official

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375920000000",
    "number": "1013191006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22826 36TH AVE SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980216203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18520 101ST AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113804",
            "telephone_number": "425-486-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKE HERBISON DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2013-08-08",
        "status": "A",
        "authorized_official_last_name": "HERBISON",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "425-486-2727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00011059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Birkeland & Associates, P.S.
• Erin Elizabeth Bishop
• Black Space LLC
• Sydney Blackman, LMP
• Patricia Blaine, L.AC.
• Brieona Blake
• Madison Charvet Blake I
• Grace Emma Blanch
• Allison Ray Blevins, LMP
• Jade Blocker

• Dentist in Bothell, WA
• Providers in Bothell, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.