Mike C Blankenship, DDS
Individual provider Active NPI General Practice Dentistry · Mebane, NC
NPI 1124008396 · NPPES record last updated Jul 12, 2019
Key facts
- NPI
- 1124008396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 4323 (NC)
- Practice address
- 106 Millstead Dr
Mebane, NC 27302-7165 - Phone
- (919) 563-4300
- NPI assigned
- Jan 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4323 | NC | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4323 | NC | Yes |
Addresses
Primary practice location
106 Millstead Dr
Mebane, NC 27302-7165
Mailing address
106 Millstead Dr
Mebane, NC 27302-7165
Phone (919) 563-4300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 90842 | Medicaid | NC |
Other providers in Mebane, NC
- Tina Ann Betancourt
- Bio-Medical Applications of North Carolina Inc.
- Blakeslee Medical
- Ashley Blankenship
- Michael Blankenship
- Bliss Medical Group PA
- Laura Katherine Bliss
- Bloom Therapy and Wellness
- Maud Boateng
- Jason Maxwell Bohrer
All providers in Mebane, NC · General Practice Dentistry in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.