Robert A Blake, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14749 Issued in MA

Practice address

50 West St
Beverly, MA 01915-2228

Phone

(978) 927-3515

Fax

(978) 927-7686

NPI assigned

Sep 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356442446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LANTHORN LN",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019154721",
            "telephone_number": "978-927-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 WEST ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152228",
            "telephone_number": "978-927-3515",
            "fax_number": "978-927-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "14749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynne C Bishop, MA LMHC
• Tammy Bishop, M.S., O.T.R.L.
• Cynthia C Bjorlie, MD
• Joel Leslie Black, DMD
• Patricia J Black
• Daniel Seth Blander, MD
• Shanna L Blaney, BA
• Monique Renee Bleau, OTR/L
• Lauren Bloomer
• Blueberry Hill Operator LLC (Blueberry Hill Rehabilitation and Healthcare Center)

• General Practice Dentistry in Beverly, MA
• Providers in Beverly, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.