Joshua Blanton-Dickens, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

18595 Issued in MT

Practice address

180 Timberwolf Pkwy
Kalispell, MT 59901-1218

Phone

(831) 801-1587

NPI assigned

Mar 30, 2016

Last updated

Aug 16, 2021By 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 2

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

Previously, effective Aug 18, 2020 through Aug 18, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Kalispell Oral Surgery Center LLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Kalispell, MT
  • NPI 1710652938
  Authorized official Same address or phone

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1063875946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 TIMBERWOLF PKWY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011218",
            "telephone_number": "831-801-1587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 TIMBERWOLF PKWY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011218",
            "telephone_number": "831-801-1587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 13th St E",
            "address_purpose": "LOCATION",
            "city": "Whitefish",
            "state": "MT",
            "postal_code": "599372964",
            "country_code": "US",
            "telephone_number": "406-755-6014",
            "fax_number": "406-755-6094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANTON-DICKENS",
        "first_name": "JOSHUA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MT",
            "license": "18595",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MT",
            "license": "18595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence P Bischoff III, LCPC, LMHC-A (WA)
• Frank Seisaku Bishop, MD
• Devon Michelle Blades
• Robert J Blair, MD
• Heather Neal Blanchard, DDS
• James P Blasingame, MD
• Rheanna Blasius, LPN
• Deborah Blauvelt, RDH, LAP
• Lottie Lucille Block, FNP
• Blue Goddess LLC

• Oral & Maxillofacial Surgery (D.M.D.) in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.