Brent L Blaylock DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4970 Issued in NC

Legal business name

BRENT L BLAYLOCK DDS PA

Practice address

3206 Old Chapel Hill Rd Ste 300
Durham, NC 27707-3688

Phone

(919) 493-8036

Fax

(919) 493-6060

NPI assigned

Aug 17, 2006

Last updated

Jul 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brent Lashley Blaylock, DDSNPI 1326151978

Title

Owner President

Phone

(919) 493-8036

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brent Lashley Blaylock, DDS

  • General Practice Dentistry
  • Durham, NC
  • NPI 1326151978
  NPD (past) Authorized official

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1194838755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 OLD CHAPEL HILL RD STE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073688",
            "telephone_number": "919-493-8036",
            "fax_number": "919-493-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3206 OLD CHAPEL HILL RD STE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073688",
            "telephone_number": "919-493-8036",
            "fax_number": "919-493-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT L BLAYLOCK DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "BLAYLOCK",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "LASHLEY",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "919-493-8036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "4970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clare Ann Brennan, PT
• James Matthew Brennan, M.D.
• Jennifer D Brennan, DPT
• Kandyce S. Brennan, CNM, MSN
• Mary Kathrine Brennan
• Dara S Breslin, M.D.
• Moira Elizabeth Breslin, M.D.
• Elizabeth Schell Bressler, M.D.
• Garrett Schell Bressler, MD
• Peter B Bressler, MD

• General Practice Dentistry in Durham, NC
• Providers in Durham, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.