NPIMap

Organization Active NPI

Blake Drew DMD, PC

Doing business as Drew Family Dentistry

  • General Practice Dentistry
  • Bend, OR
National Provider Identifier
1295247674
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9366 Issued in OR
Legal business name
BLAKE DREW DMD, PC
Doing business as
Drew Family Dentistry
Practice address
2215 NW Shevlin Park Rd Ste 110
Bend, OR 97703-7195
Phone
(541) 610-3270
Fax
(541) 279-2356
NPI assigned
Oct 25, 2017
Last updated
Oct 25, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Authorized official

Name
Blake B Drew, DMDNPI 1205092954
Title
Owner/President
Phone
(971) 226-6029

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D9366 OR Primary

Addresses

Primary practice location

2215 NW Shevlin Park Rd Ste 110
Bend, OR 97703-7195

Mailing address

2323 NW High Lakes Loop
Bend, OR 97703-7056
Phone (971) 226-6029

Other names 1

  • Drew Family Dentistry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250625004283 OR DME Supplier - Oral Surgery - Dentist 9931447240 Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

2215 NW Shevlin Park Rd
Ste 110
Bend, OR 97703
Phone (541) 610-3270

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508889600000",
    "number": "1295247674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 NW HIGH LAKES LOOP",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037056",
            "telephone_number": "971-226-6029",
            "fax_number": "541-279-2356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 NW SHEVLIN PARK RD STE 110",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037195",
            "telephone_number": "541-610-3270",
            "fax_number": "541-279-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKE DREW DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A",
        "authorized_official_last_name": "DREW",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "971-226-6029",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drew Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.