Active NPI
Blake Swonke
- General Practice Dentistry
- Houston, TX
National Provider Identifier
1144925942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 40380
- Practice address
- 6410 Fannin St Ste 310
Houston, TX 77030-3004 - Phone
- (713) 486-4000
- NPI assigned
- Apr 3, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 40380 | TX | Primary |
Addresses
Primary practice location
6410 Fannin St Ste 310
Houston, TX 77030-3004
Mailing address
954 Fisher St Unit E
Houston, TX 77018-5369
Phone (832) 477-7470
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 |
|---|---|---|---|
| 40380 | TX | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1144925942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "954 FISHER ST UNIT E",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770185369",
"telephone_number": "832-477-7470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6410 FANNIN ST STE 310",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770303004",
"telephone_number": "713-486-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWONKE",
"first_name": "BLAKE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-03",
"last_updated": "2024-10-09",
"certification_date": "2024-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "40380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.