Blacklick Family Dental, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BLACKLICK FAMILY DENTAL, INC

Practice address

6911 E Broad St
Columbus, OH 43213-1518

Phone

(614) 864-4800

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Liljana Petrova, DDSNPI 1528284825

Title

President

Phone

(614) 864-4800

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Liljana Petrova

  • General Practice Dentistry
  • Columbus, OH
  • NPI 1528284825
  NPD (past) Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124244413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131518",
            "telephone_number": "614-864-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 E BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131518",
            "telephone_number": "614-864-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKLICK FAMILY DENTAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETROVA",
        "authorized_official_first_name": "LILJANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-864-4800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Jane Blackburn
• Shelley L Blackburn, MD
• Angela Kathryn Blackerby, COTA/L
• Michele Blackford, MSW, LSW
• William D Blackhurst, M.D.
• John D Blackman, MD
• Miricle Blackman
• Tammy Marie Blackmon, APRN-CNP
• Emily Renee Blackmore, CNP
• Jozette Blackshear

• General Practice Dentistry in Columbus, OH
• Providers in Columbus, OH by specialty
• General Practice Dentistry in Ohio

• 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.