Jared V Bloxham, D.D.S.

Primary specialty

Orofacial Pain DentistryTaxonomy code 1223X2210X

License

10135 Issued in WA

Practice address

1363 Columbia Park TRL Ste 101
Richland, WA 99352-4770

Phone

(509) 578-5770

Fax

(509) 578-5774

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 26, 2024 through Feb 26, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: columbiacenterforsleepapneaandtmj.jaredbloxham@157620.advancedmd-direct.com

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.

• Creekside Dental Sleep Therapy PLLC

  • Dentist
  • Kennewick, WA
  • NPI 1538527114

  Single Specialty

  NPD (past)
• Csdental, PLLC

  • General Practice Dentistry
  • Kennewick, WA
  • NPI 1679642151
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1386741239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 COLUMBIA PARK TRL STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524770",
            "telephone_number": "509-578-5770",
            "fax_number": "509-578-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1363 COLUMBIA PARK TRL STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524770",
            "telephone_number": "509-578-5770",
            "fax_number": "509-578-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOXHAM",
        "first_name": "JARED",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "10135",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orofacial Pain",
            "state": "WA",
            "license": "10135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5049150",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy R Blanchard, M.D.
• Hayde Blanco
• Timothy Seth Blanscett, ARNP
• Dale J Blatter, PT
• Blazing Grace Medical, LLC
• BLTS Enterprises
• Blue Mountain Pharmacies LLC
• Katy M. Bluher, L.M.P
• Lilya Bobov, CBT
• Ronnie Sheen Bodden, MC15772 SC10033

• Orofacial Pain Dentistry in Richland, WA
• Providers in Richland, WA by specialty
• Orofacial Pain Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.