David R Blanck, DDS
Individual provider Active NPI General Practice Dentistry · Burlington, VT
NPI 1205950672 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1205950672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1128 (VT)
- Practice address
- 66 Colchester Ave
Burlington, VT 05401 - Phone
- (802) 862-8348
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1128 | VT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Randall a. Miller, DDS, PC | General Practice | Past | Accepting new patients |
| Integrative Dental Care | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1128 | VT | Yes |
Addresses
Primary practice location
66 Colchester Ave
Burlington, VT 05401
Mailing address
66 Colchester Ave
Burlington, VT 05401
Phone (802) 862-8348
Other providers in Burlington, VT
- Kimberly Blake
- Colin Henry Blanchard
- Meaghan Blanchard
- Kelly Curtis Blanchet
- Kristin Blanchette
- Javier Blanco
- Aaron Blau
- Stephanie M. Bless
- Michele Christine Bliss
- Wendell Adam Bliss
All providers in Burlington, VT · General Practice Dentistry in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.