Jacee Blades, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7108 Issued in LA

Practice address

2030 N Causeway Blvd
Mandeville, LA 70471-3116

Phone

(985) 626-3338

NPI assigned

Jun 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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 and National Provider Directory roles.

• Northlake Dental LLC

  • General Practice Dentistry
  • Mandeville, LA
  • NPI 1922266576
  NPD

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1336765452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 N CAUSEWAY BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713116",
            "telephone_number": "985-626-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 N CAUSEWAY BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713116",
            "telephone_number": "985-626-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLADES",
        "first_name": "JACEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA STATE BOARD OF DENTISTRY",
            "identifier": "7108",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MANDEVILLE",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2030 N Causeway Blvd",
            "city": "Mandeville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704713116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bianchini-Brennan/Stabler, LLC
• Bianchini-Holcomb
• Katherine Bickham, DPT
• Marleen Billiot, LCSW
• Andre Joseph Birdsall, DDS
• Nancy Blake
• Martha Blanchard
• Alison Cecile Blanchat, RPH
• Sara E. Blomkalns, LCSW
• Blooming Minds Therapy LLC

• General Practice Dentistry in Mandeville, LA
• Providers in Mandeville, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.