Active NPI
Clayton Blackwell
- Dentist
- Colmar, PA
National Provider Identifier
1386404812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS044613
- Practice address
- 2406 N Broad St
Colmar, PA 18915-9701 - Phone
- (215) 712-8895
- NPI assigned
- Mar 21, 2024
- Last updated
- Jun 23, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS044613 | PA | Primary |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DS044613 | PA | |
| Oral Medicine Dentistry | 125Q00000X | DS044613 | PA |
Addresses
Primary practice location
2406 N Broad St
Colmar, PA 18915-9701
Mailing address
2406 N Broad St
Colmar, PA 18915-9701
Phone (215) 712-8895
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS044613 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782172800000",
"number": "1386404812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2406 N BROAD ST",
"city": "COLMAR",
"state": "PA",
"postal_code": "189159701",
"telephone_number": "215-712-8895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2406 N BROAD ST",
"city": "COLMAR",
"state": "PA",
"postal_code": "189159701",
"telephone_number": "215-712-8895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELL",
"first_name": "CLAYTON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-21",
"last_updated": "2026-06-23",
"certification_date": "2026-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS044613",
"primary": true
},
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "PA",
"license": "DS044613",
"primary": false
},
{
"code": "125Q00000X",
"taxonomy_group": "",
"desc": "Dentist, Oral Medicine",
"state": "PA",
"license": "DS044613",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colmar, PA
- Karen G Aubert, RD, CDE, LDN
- Avp Clinical Business Consultants
- Maria J Bader, M.S.,L.P.C.
- Umair Bajwa, DDS
- Bela P Patel DMD & Associates Inc (E Z Smile Family Dental)
- Bucks Mont Imaging Associates Inc.. (Colmar Imaging Center)
- Joel Chanen, DDS
- Robin Elyse Chanen, DMD
- Childway Pediatric Services
- Carol Lynn Cleaveland, PHD, LSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.