Jupiter Prosthodontics

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN9551 Issued in FL

Legal business name

JUPITER PROSTHODONTICS

Practice address

200 Central Blvd
Ste a
Jupiter, FL 33458

Phone

(561) 745-5550

Fax

(561) 745-8442

NPI assigned

Nov 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Roy C Blake III, DDS MSD

Title

Owner Manager

Phone

(561) 745-5550

Specialties & licenses 2

Addresses

Other names 1

• Jupiter Institute for Prosthodontics & Implant Dentistry Former legal business name

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114006434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CENTRAL BLVD",
            "address_2": "STE A",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-745-5550",
            "fax_number": "561-745-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CENTRAL BLVD",
            "address_2": "STE A",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-745-5550",
            "fax_number": "561-745-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUPITER PROSTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "561-745-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS MSD"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN9551",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN16512",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jupiter Institute for Prosthodontics & Implant Dentistry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jupiter Pediatric Associates, PA
• Jupiter Pediatric Dentistry, LLC
• Jupiter Physical Therapy
• Jupiter Primary Care Group Inc
• Jupiter Primary Care Group Inc
• Jupiter Rehab and Health Center, LLC
• Jupiter Senior Living LLC
• Jupiter Senior Living, LLC
• Jupiter Smile Care Dentistry LLC
• Jupiter Spinal Health Center

• Prosthodontics in Jupiter, FL
• Providers in Jupiter, FL by specialty
• Prosthodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.