Samuel Ernest Bleakley, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19413 Issued in CA

Practice address

1601 McHenry Village Way Ste 1
Modesto, CA 95350-4338

Phone

(209) 577-1313

Fax

(209) 577-8584

NPI assigned

Jul 14, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Rimmie K Pandher DMD Inc

  dba Dental Design Studio

  • Dental Clinic/Center
  • Modesto, CA
  • NPI 1649033804
  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023034204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MCHENRY VILLAGE WAY STE 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504338",
            "telephone_number": "209-577-1313",
            "fax_number": "209-577-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 MCHENRY VILLAGE WAY STE 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504338",
            "telephone_number": "209-577-1313",
            "fax_number": "209-577-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEAKLEY",
        "first_name": "SAMUEL",
        "middle_name": "ERNEST",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "19413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hilda Blanco
• Stephanie Bland
• Bradley S. Blankenship, M.D.
• Sara Blankenship
• Vivian Blas, B.A.
• Tyra Bledsoe
• Ashley Blevins
• Laura Blom, LCSW
• Blossom Speech and Language Therapy
• Blossom Speech and Language Therapy TN, Inc.

• General Practice Dentistry in Modesto, CA
• Providers in Modesto, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.