Corey Coleman Blankenship, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE 60192058 Issued in WA

Practice address

280 2ND St
Cathlamet, WA 98612-9400

Phone

(360) 795-3235

Fax

(360) 544-0123

NPI assigned

Jan 21, 2011

Last updated

Aug 26, 2015By 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

Enrolled in WA

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": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1023313160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 2ND ST",
            "city": "CATHLAMET",
            "state": "WA",
            "postal_code": "986129400",
            "telephone_number": "360-795-3235",
            "fax_number": "360-544-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 2ND ST",
            "city": "CATHLAMET",
            "state": "WA",
            "postal_code": "986129400",
            "telephone_number": "360-795-3235",
            "fax_number": "360-544-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "COREY",
        "middle_name": "COLEMAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-21",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 60192058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dugan Anderson
• Kristie Marie Andreas, FNP
• Linda J Bannerman, MA
• Mary Danelle Barlow, R.N
• Alexander K Bell, SUDPT
• Brighton Diversion Services Inc.
• Cathlamet Fire Dept First Aid Division
• Cathlamet Pharmacy
• Cathlamet Pharmacy Inc (Cathlamet Pharmacy)
• Elizabeth Ann Clark

• General Practice Dentistry in Cathlamet, WA
• Providers in Cathlamet, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; 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.