NPIMap

Organization Active NPI

J. Blake Perkins, DDS, PS

  • Dentist
  • Vancouver, WA
National Provider Identifier
1104084276
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00008724 Issued in WA
Legal business name
J. BLAKE PERKINS, DDS, PS
Practice address
2616 NE 112TH Ave
Vancouver, WA 98684-4284
Phone
(360) 892-7780
Fax
(360) 892-0181
NPI assigned
May 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Authorized official

Name
Dr. Justin Blake Perkins, D.D.S.
Title
Owner
Phone
(360) 892-7780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE00008724 WA Primary

Addresses

Primary practice location

2616 NE 112TH Ave
Vancouver, WA 98684-4284

Mailing address

2616 NE 112TH Ave
Vancouver, WA 98684-4284
Phone (360) 892-7780

Other names 1

  • Today's Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

2616 NE 112th Ave
Vancouver, WA 98684
Phone (360) 892-7780

Practitioners & affiliated clinicians

Practitioners 4

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": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1104084276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 NE 112TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986844284",
            "telephone_number": "360-892-7780",
            "fax_number": "360-892-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 NE 112TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986844284",
            "telephone_number": "360-892-7780",
            "fax_number": "360-892-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. BLAKE PERKINS, DDS, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-892-7780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00008724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Today's Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.