Rodney Mark Blackmore, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19938 Issued in TX

Practice address

9901 Valley Ranch Pkwy E Ste 1001
Irving, TX 75063-7175

Phone

(972) 869-4683

Fax

(972) 869-4226

NPI assigned

Oct 18, 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

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093896623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1376 PRAIRIE DR",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750675566",
            "telephone_number": "972-869-4683",
            "fax_number": "972-869-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 VALLEY RANCH PKWY E STE 1001",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750637175",
            "telephone_number": "972-869-4683",
            "fax_number": "972-869-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMORE",
        "first_name": "RODNEY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Adams Black, M.D.
• Jason Black, D.C.
• Blackburn Woolfolk Dermatology, PLLC
• Aleya Renea Blackman, DC
• Margaret C Blackmon, CPNP
• Hannah Elaine Blaeser, MS, SLP CF
• Kyle Matthew Blake, M.D.
• Marcia T Blake, LPC
• Lissette Blanco
• Samuel Adam Blankenburg, DC

• General Practice Dentistry in Irving, TX
• Providers in Irving, TX by specialty
• General Practice Dentistry in Texas

• 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.