Geoffrey W Blatter, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D9925 Issued in OR

Practice address

100 E Oak St
Lebanon, OR 97355-4135

Phone

(541) 451-1176

Fax

(541) 451-1424

NPI assigned

Aug 1, 2013

Last updated

Nov 8, 2023By 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

Locations

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.

• Geoffrey W Blatter, DMD, PC

  dba Lebanon Family Dental

  • Dental Clinic/Center
  • Lebanon, OR
  • NPI 1528585775
  NPD Authorized official
• John M. Shader DMD, PC

  • General Practice Dentistry
  • Lebanon, OR
  • NPI 1356578421
  NPD (past)

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1326470386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E OAK ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554135",
            "telephone_number": "541-451-1176",
            "fax_number": "541-451-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E OAK ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554135",
            "telephone_number": "541-451-1176",
            "fax_number": "541-451-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATTER",
        "first_name": "GEOFFREY",
        "middle_name": "W",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-01",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Bjarvin
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• Eric Bleem
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• Charise Anne Blodgett
• Drew Blumberg

• Dentist in Lebanon, OR
• Providers in Lebanon, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.