Brian Chris Blalock, D.D.S., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

A06347 Issued in CA

Practice address

145 Cedar Rd
Suite B
Vista, CA 92083-5103

Phone

(760) 724-8891

Fax

(760) 724-7950

NPI assigned

Feb 27, 2007

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• S Tchon & Da Smith DDS MD Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Vista, CA
  • NPI 1861882086
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437286580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 CEDAR RD",
            "address_2": "SUITE B",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920835103",
            "telephone_number": "760-724-8891",
            "fax_number": "760-724-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 CEDAR RD",
            "address_2": "SUITE B",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920835103",
            "telephone_number": "760-724-8891",
            "fax_number": "760-724-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "BRIAN",
        "middle_name": "CHRIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "A06347",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS23",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Bittle, C.PED
• Alexis Zipporrah Bituin-Harris
• Michele Bjornson, NP
• Jennifer Michelle Black, M.D.
• Allison Blaha, C.PED
• Christina Blanchard, MS, RD
• Veronica Blanco
• Alicia Blanton
• Jordyn Blommaert
• Chelsea Bloom, OTR/L

• Oral and Maxillofacial Surgery (Dentist) in Vista, CA
• Providers in Vista, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• 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.