Individual provider Active NPI

Blake Schreck

  • General Practice Dentistry
  • Kansas City, KS
National Provider Identifier
1336030584
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62384 Issued in KS
Practice address
7933 State Ave # 100-101
Kansas City, KS 66112-2468
Phone
(913) 213-6973
NPI assigned
Jul 14, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 62384 KS Primary

Addresses

Primary practice location

7933 State Ave # 100-101
Kansas City, KS 66112-2468

Mailing address

380 W 22ND St Apt 214
Kansas City, MO 64108-2052
Phone (660) 254-4422

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

LicenseStateTypeSpecialty
62384KSMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1336030584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 W 22ND ST APT 214",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082052",
            "telephone_number": "660-254-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7933 STATE AVE # 100-101",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661122468",
            "telephone_number": "913-213-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRECK",
        "first_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "62384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.