Harry Blackmon Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2392 Issued in SC

Practice address

500 E Main St
Bennettsville, SC 29512-3210

Phone

(843) 479-4085

Fax

(843) 479-8991

NPI assigned

Dec 7, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jun 3, 2016 through Jun 3, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1154306751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E MAIN ST",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295123210",
            "telephone_number": "843-479-4085",
            "fax_number": "843-479-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E MAIN ST",
            "city": "BENNETTSVILLE",
            "state": "SC",
            "postal_code": "295123210",
            "telephone_number": "843-479-4085",
            "fax_number": "843-479-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "HARRY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "2392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002392",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia E Berrios, M.D.
• Luis Alberto Berrios, M.D.
• Bio-Medical Applications of South Carolina, Inc. (Fresenius Medical Care Bennettsville)
• Leandria Nichelle Bivens, LISW-CP
• Sara Blackman
• Stephanie Marie Blackmon, RN
• Mary Elizabeth Blackwell
• Latisha Rochelle Bowens, BA
• Emerald J Bowman, MA
• Lashandra Bradford

• General Practice Dentistry in Bennettsville, SC
• Providers in Bennettsville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.