Blake Isaacson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7002323-9922 Issued in UT

Practice address

2674 S 1800 E
Salt Lake City, UT 84106-4016

Phone

(801) 822-9756

NPI assigned

Jun 24, 2014

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

Medicare fee-for-service enrollment

Enrolled in UT

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• UT PPO D-SNP

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1184039505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2674 S 1800 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841064016",
            "telephone_number": "801-822-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2674 S 1800 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841064016",
            "telephone_number": "801-822-9756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAACSON",
        "first_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "7002323-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trisha Lynn Irving
• Michelle Veronica Isaac-Doherty, LCSW
• Jorge Cesar Isaac, M.D,
• Luke Thomas Isaac
• Zachary Stewart Isaac
• Patrice H Isabella, R.D.
• Charlene Fuatai Isaia
• Sheila Isakson
• Erin Jessica Isenberg, PA-C
• John William Ishmael, RN - BSN

• Dentist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.