Paul M Blank D.D.S., P.C.

Primary specialty

Respite CareTaxonomy code 385H00000X

License

2901015109 Issued in MI

Legal business name

PAUL M BLANK D.D.S., P.C.

Practice address

213 Spring St
Three Rivers, MI 49093-2150

Phone

(269) 279-5278

Fax

(269) 278-1014

NPI assigned

Sep 9, 2008

Last updated

Sep 9, 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

Janice E Jackson

Title

Office Manager

Phone

(269) 279-5278

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1225287790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 SPRING ST",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490932150",
            "telephone_number": "269-279-5278",
            "fax_number": "269-278-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 SPRING ST",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490932150",
            "telephone_number": "269-279-5278",
            "fax_number": "269-278-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL M BLANK D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "269-279-5278"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MI",
            "license": "2901015109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2826055",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Parvati Uma LLC (Three Rivers Pharmacy)
• Keyur Patel, MD
• Sunil H Patel, RPH
• Veera Jayantilal Patel, M.D.
• Patel, Veera Jayantilal
• Chelsea Elizabeth Peavey
• Dana Pellegrino, PHD, BCBA-D
• Betsy Penn
• Melanie Ann Peppler, MA LLP
• Mallory Elise Phillips

• Respite Care in Three Rivers, MI
• Providers in Three Rivers, MI by specialty
• Respite Care in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.