Lauren E Blaich, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2016017396 Issued in MO

Practice address

2700 Kanell Blvd
Poplar Bluff, MO 63901-3041

Phone

(573) 785-0111

Fax

(573) 785-3840

NPI assigned

Jun 1, 2016

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1336597186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013041",
            "telephone_number": "573-785-0111",
            "fax_number": "573-785-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013041",
            "telephone_number": "573-785-0111",
            "fax_number": "573-785-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAICH",
        "first_name": "LAUREN",
        "middle_name": "E",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2016017396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Denise Blackburn, MCD, CFY-SLP
• Malarie Blackwell, PHARMD
• George F Blaich IV, D.M.D.
• George Frederick Blaich V, D.D.S.
• John R Blaich, D.M.D.
• Travis D Blaich, D.D.S.
• Elizabeth Marrie Bland
• Staci Blankenship, OTR/L
• Timothy Blankenship, O.D.
• Linda Kay Blasingame, APRN

• General Practice Dentistry in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.