Lacey Todd Blackwell, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401417212 Issued in VA

Practice address

5954 Harbour Park Dr
Midlothian, VA 23112-2163

Phone

(804) 739-1600

NPI assigned

Oct 8, 2020

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1063019404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6206 DUSTIN DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262510",
            "telephone_number": "540-793-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5954 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122163",
            "telephone_number": "804-739-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "LACEY",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jefferson Thair Blackburn, DDS
• Margaret Turner Blackburn, M.ED., CCC-SLP
• Jeanette Blackshear
• Dabney Blackwell
• Elizabeth Louise Blackwell
• Lindsey P Blake, DPT
• Michael Blake, DPT
• Peter Patrick Blakey, M.D.
• Marcus Thea Bland, M.ED,RBT
• Emily Blankinship, M.S.W., L.C.S.W.

• Dentist in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Dentist in Virginia

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