Active NPI
Raymond Edward Blanchard, DDS
- General Practice Dentistry
- Cross Plains, WI
National Provider Identifier
1245409465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5001289-015
- Practice address
- 1802 Main St
Cross Plains, WI 53528-9770 - Phone
- (608) 798-3200
- NPI assigned
- Feb 21, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5001289-015 | WI | Primary |
Addresses
Primary practice location
1802 Main St
Cross Plains, WI 53528-9770
Mailing address
1802 Main St
Cross Plains, WI 53528-9770
Phone (608) 798-3200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5001289015 | Other | WI | DENTAL STATE LICENSE DEPT |
Other names 1
- Ray Blanchard
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5001289-015 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203552000000",
"number": "1245409465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 MAIN ST",
"city": "CROSS PLAINS",
"state": "WI",
"postal_code": "535289770",
"telephone_number": "608-798-3200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 MAIN ST",
"city": "CROSS PLAINS",
"state": "WI",
"postal_code": "535289770",
"telephone_number": "608-798-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANCHARD",
"first_name": "RAYMOND",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-21",
"last_updated": "2008-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "5001289-015",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL STATE LICENSE DEPT",
"identifier": "5001289015",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "RAY",
"last_name": "BLANCHARD",
"credential": "DDS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Cross Plains, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.