Individual provider Active NPI

Blake Edward Trabuchi-Downey, D.M.D

  • Dentist
  • Vineland, NJ
National Provider Identifier
1457709461
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI02640700 Issued in NJ
Practice address
717 E Elmer St
Vineland, NJ 08360-4758
Phone
(856) 213-6858
Fax
(856) 500-6356
NPI assigned
May 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DI02640700 NJ Primary

Addresses

Primary practice location

717 E Elmer St
Vineland, NJ 08360-4758

Mailing address

717 E Elmer St
Vineland, NJ 08360-4758
Phone (856) 213-6858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20160817002860 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7012202898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI02640700NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Trabuchi & Trabuchi D.D.S., P.a. PastSince Apr 17, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1457709461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 E ELMER ST",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083604758",
            "telephone_number": "856-213-6858",
            "fax_number": "856-500-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 E ELMER ST",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083604758",
            "telephone_number": "856-213-6858",
            "fax_number": "856-500-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRABUCHI-DOWNEY",
        "first_name": "BLAKE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI02640700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.