Blake Essner, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2014020317 Issued in MO

Practice address

220 Southland Dr
Sikeston, MO 63801-4403

Phone

(573) 471-4167

Fax

(573) 471-4212

NPI assigned

Jun 30, 2014

Last updated

Jun 30, 2014By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • Sikeston, MO
  • NPI 1104045475
  NPD (past)
• Southeast Missouri Health Network

  dba Southeast Health on Wheels Mobile Van

  • Federally Qualified Health Center (FQHC)
  • Malden, MO
  • NPI 1720209794
  NPD (past)

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1235544123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "NEW MADRID",
            "state": "MO",
            "postal_code": "638690400",
            "telephone_number": "573-748-2404",
            "fax_number": "573-748-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SOUTHLAND DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638014403",
            "telephone_number": "573-471-4167",
            "fax_number": "573-471-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESSNER",
        "first_name": "BLAKE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2014020317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Wade Elliott, ATC
• Encore Home Health Care Inc (Rotech)
• Elizabeth Engram
• Kayla Erlbacher
• Laura Elizabeth Eskew
• Malerie Essner, DPT
• Brooke Anne Evans
• Family Affair Home Healthcare LLC
• Family First Medical Center, Inc (Sikeston Family Medical)
• Family Medicine of Southeast Missouri, LLC

• General Practice Dentistry in Sikeston, MO
• Providers in Sikeston, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.