NPIMap

Organization Active NPI

The Blevins Legacy Dental

  • General Practice Dentistry
  • Proctorville, OH
National Provider Identifier
1053409490
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21386 Issued in OH
Legal business name
THE BLEVINS LEGACY DENTAL
Practice address
148 State Route 775
Proctorville, OH 45669-8839
Phone
(740) 886-7000
Fax
(740) 886-5518
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Melanie Lynn Blevins, D.D.S.NPI 1902994338
Title
Dentist/Owner
Phone
(740) 886-7000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 21386 OH Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 3484 WV

Addresses

Primary practice location

148 State Route 775
Proctorville, OH 45669-8839

Mailing address

PO Box 459
Proctorville, OH 45669-0459
Phone (740) 886-7000

Other names 1

  • Legacy Dental Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053409490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456690459",
            "telephone_number": "740-886-7000",
            "fax_number": "740-886-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 STATE ROUTE 775",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456698839",
            "telephone_number": "740-886-7000",
            "fax_number": "740-886-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BLEVINS LEGACY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLEVINS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "740-886-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "21386",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3484",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Proctorville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.