Blanco Jamis Dental Group, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 16115 Issued in FL

Legal business name

BLANCO JAMIS DENTAL GROUP, P.A.

Practice address

5701 SW 107TH Ave Ste 101
Miami, FL 33173-1276

Phone

(305) 262-4604

Fax

(305) 239-8999

NPI assigned

Aug 15, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jorge L Blanco, DMDNPI 1609046960

Title

President

Phone

(305) 262-4604

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jorge L Blanco, D.M.D

  • Dentist
  • Miami, FL
  • NPI 1609046960
  NPD Authorized official
• Farid Blanco, D.M.D.

  • Dentist
  • Hialeah, FL
  • NPI 1154569473

  General Practice

  NPD (past)
• Kemel Jalil Blanco, D.M.D.

  • Dentist
  • Hialeah, FL
  • NPI 1255571824
  NPD (past)

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

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637107200000",
    "number": "1265780704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440308",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331440308",
            "telephone_number": "305-262-4604",
            "fax_number": "305-239-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 SW 107TH AVE STE 101",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331731276",
            "telephone_number": "305-262-4604",
            "fax_number": "305-239-8999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5511 SW 8th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331342272",
            "country_code": "US",
            "telephone_number": "305-262-4604",
            "fax_number": "305-239-8999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4765 W 8th Ave Fl 4",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330123554",
            "country_code": "US",
            "telephone_number": "305-262-4604",
            "fax_number": "305-239-8999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLANCO JAMIS DENTAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A",
        "authorized_official_last_name": "BLANCO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-262-4604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 16115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609046960",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lenibet Blanco Gonzalez
• Lourdes Blanco Gonzalez
• Victor Manuel Blanco Gonzalez, RBT
• Jesica Blanco Hernandez
• Blanco Home Health Care Corporation
• Vivian Blanco Lezcano
• Yumay Blanco Llanes
• Adrian Emelio Blanco Lopez, RBT
• Zuzel Blanco Lopez
• Yanela Blanco Martinez, APRN

• General Practice Dentistry in Miami, FL
• Providers in Miami, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.