Terry C Blanks Jr DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

005526 Issued in FL

Legal business name

TERRY C BLANKS JR DDS PA

Practice address

895 South Dexter Ave
Deland, FL 32720

Phone

(386) 738-2002

Fax

(386) 738-9523

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Terry C Blanks Jr., DDSNPI 1154660819

Title

Owner

Phone

(386) 738-2002

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Terry Cleve Blanks Jr., DENTIST

  • Dentist
  • Deland, FL
  • NPI 1154660819
  NPD (past) Authorized official

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1184782518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 SOUTH DEXTER AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "32720",
            "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 SOUTH DEXTER AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "32720",
            "telephone_number": "386-738-2002",
            "fax_number": "386-738-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY C BLANKS JR DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "BLANKS",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-738-2002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "005526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077171600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Taylor
• James H Taylor, M.D.
• Scott Robert Taylor
• Summer L Taylor, PTA
• Teresa N Gascon (Deland Alf)
• Helen Ann Testa, RPH
• The Alliance Community for Retirement Living, Inc. (The Center for the Assisted Living of the Alliance Community)
• The Devereux Foundation
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Florida Lutheran)
• The Evangelical Lutheran Good Samaritan Society (Florida Lutheran Retirement Center)

• General Practice Dentistry in Deland, FL
• Providers in Deland, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.