Terry Cleve Blanks Jr., DENTIST

Primary specialty

DentistTaxonomy code 122300000X

License

0005526 Issued in FL

Practice address

895 S. Dexter Ave
Deland, FL 32720

Phone

(386) 738-2002

Fax

(386) 738-9523

NPI assigned

Jan 31, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Terry C Blanks Jr DDS PA

  • General Practice Dentistry
  • Deland, FL
  • NPI 1184782518
  NPD (past) Authorized official

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1154660819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 S DEXTER AVE",
            "address_2": "P.O.BOX 3544",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327206619",
            "telephone_number": "386-738-2002",
            "fax_number": "386-738-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 S. DEXTER AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "32720",
            "telephone_number": "386-738-2002",
            "fax_number": "386-738-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKS",
        "first_name": "TERRY",
        "middle_name": "CLEVE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DENTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "0005526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Elisabeth Bird, MSPT, ATC, LAT
• Jeffrey William Bishop, ATC, LAT
• Wendi A Bishop
• BKD Sterling House of Deland, LLC
• Blanca Luna MD PA
• Evan Bloom, DO
• Kendra Louise Bloomer
• Blue Bird Books
• Blue Lake Post Acute LLC
• Andrew R Blum, M.D.

• Dentist in Deland, FL
• Providers in Deland, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.