Jonathan Andrew Blansett, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

3958(DDS); 37(PERIO) Issued in AR

Practice address

2522 S Pinnacle Hills Pkwy Ste 102
Rogers, AR 72758-1415

Phone

(479) 282-2812

Fax

(479) 936-8660

NPI assigned

Jul 27, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 16, 2017 through Oct 16, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1376821181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 S PINNACLE HILLS PKWY STE 102",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581415",
            "telephone_number": "479-282-2812",
            "fax_number": "479-340-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2522 S PINNACLE HILLS PKWY STE 102",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727581415",
            "telephone_number": "479-282-2812",
            "fax_number": "479-936-8660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANSETT",
        "first_name": "JONATHAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-27",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "27107",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AR",
            "license": "3958",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AR",
            "license": "3958(DDS); 37(PERIO)",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Bladow
• David Blair
• Kyle Blair, MD
• Tori Blankenship
• William Blankenship, QBHP
• Joshua Blaylock, M.D.
• Morgan Bledsoe, OTR/L
• Branden Shane Blume, PT, DPT
• Mallory Leigh Bockelman, LPC
• Body Positive Therapy, PLLC

• Periodontics in Rogers, AR
• Providers in Rogers, AR by specialty
• Periodontics in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.