Blair H. Racker, D.D.S.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

11234 Anderson St
Llu Medical Center: Oral and Maxillofacial Surgery
Loma Linda, CA 92354-2804

Phone

(909) 558-4671

NPI assigned

Jun 10, 2014

Last updated

Jun 10, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 28, 2021 through Sep 28, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Oral Surgery, PLLC

  dba Council Bluffs Oral Surgery, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Council Bluffs, IA
  • NPI 1154970655
  NPD (past)
• Omaha Oral Surgery, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Omaha, NE
  • NPI 1326402470
  NPD (past)

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1013320654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "GME OFFICE WESTERLY SUITE C",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "801-660-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "address_2": "LLU MEDICAL CENTER: ORAL AND MAXILLOFACIAL SURGERY",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACKER",
        "first_name": "BLAIR",
        "middle_name": "H.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammad Qureashi, MD
• Mahaat Mohammad Qureshi, AUD
• Rafael Rabelo Gumerato, MD
• Tiffany Ana Racataian
• Judy K Racine, NP
• Japhet A Rada, P.T.
• Patricia Radovich, CNS
• Arielle Maya Radparvar, DO
• Andrei Radulescu, M.D.,PH.D.
• Muhammad Aanish Raees, MBBS, MD

• Student in an Organized Health Care Education/Training Program in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.