Blake Patrick Nelson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10894 Issued in NC

Practice address

3066 Trenwest Dr
Winston Salem, NC 27103-3208

Phone

(828) 455-0952

NPI assigned

Jul 29, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Carpenter Dental Group, Inc.

  • Dental Clinic/Center
  • Mount Vernon, OH
  • NPI 1174613301

  General Practice

  NPD (past)

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336692060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 TRENWEST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033208",
            "telephone_number": "828-455-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 TRENWEST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033208",
            "telephone_number": "828-455-0952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8210 Floyd Curl Drive, MSC 8103",
            "address_2": "UT Health Science Center at San Antonio",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293923",
            "country_code": "US",
            "telephone_number": "210-450-3273",
            "fax_number": "210-450-2223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1684 Venture Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "OH",
            "postal_code": "430508950",
            "country_code": "US",
            "telephone_number": "740-397-4097",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16615 Riverstone Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282775748",
            "country_code": "US",
            "telephone_number": "828-455-0952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BLAKE",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-29",
        "last_updated": "2022-07-21",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025179",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather D Nelkin, PHARMD, BCOP, CPP
• Sean Patrick Nelligan, L.C.S.W., A.C.S.W.,
• Anna Kathryn Nelsen
• Nelson & Nelson Pathways, LLC
• Arnold Ernest Nelson, PH.D.
• Christie M Nelson, LPC, LCMHC
• Christopher Michael Nelson, M.D.
• Colleen E Nelson, M.A., CCC-SLP
• Elise Marie Nelson, AGNP-C
• Elizabeth Phillips Nelson

• General Practice Dentistry in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.