Active NPI
Kemel Jalil Blanco, D.M.D.
- Dentist
- Hialeah, FL
National Provider Identifier
1255571824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN16312
- Practice address
- 4765 West 8TH Ave
4TH Floor
Hialeah, FL 33012 - Phone
- (305) 823-0902
- Fax
- (305) 823-0903
- NPI assigned
- Feb 23, 2009
- Last updated
- Feb 23, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN16312 | FL | Primary |
Addresses
Primary practice location
4765 West 8TH Ave
4TH Floor
Hialeah, FL 33012
Mailing address
4765 West 8TH Ave
4TH Floor
Hialeah, FL 33012
Phone (305) 823-0902
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 |
|---|---|---|---|
| DN16312 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blanco Jamis Dental Group, P.a. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Miami, FL
- NPI 1265780704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235347200000",
"number": "1255571824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4765 WEST 8TH AVE",
"address_2": "4TH FLOOR",
"city": "HIALEAH",
"state": "FL",
"postal_code": "33012",
"telephone_number": "305-823-0902",
"fax_number": "305-823-0903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4765 WEST 8TH AVE",
"address_2": "4TH FLOOR",
"city": "HIALEAH",
"state": "FL",
"postal_code": "33012",
"telephone_number": "305-823-0902",
"fax_number": "305-823-0903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANCO",
"first_name": "KEMEL",
"middle_name": "JALIL",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-02-23",
"last_updated": "2009-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN16312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hialeah, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.