Active NPI
Rachel Blakeley
- Endodontics
- Plantation, FL
National Provider Identifier
1104499227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN26323
- Practice address
- 8320 W Sunrise Blvd
Plantation, FL 33322-5435 - Phone
- (954) 474-9660
- NPI assigned
- Jul 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN26323 | FL | Primary |
Addresses
Primary practice location
8320 W Sunrise Blvd
Plantation, FL 33322-5435
Mailing address
790 E Broward Blvd Apt 1907
Fort Lauderdale, FL 33301-3074
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN26323 | FL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626652800000",
"number": "1104499227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 E BROWARD BLVD APT 1907",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333013074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8320 W SUNRISE BLVD",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333225435",
"telephone_number": "954-474-9660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKELEY",
"first_name": "RACHEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-19",
"last_updated": "2021-07-19",
"certification_date": "2021-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN26323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plantation, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.