John Robert Blakemore, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30.013848 Issued in OH

Practice address

26777 Lorain Road
#600
North Olmsted, OH 44070-3222

Phone

(440) 734-3131

Fax

(440) 734-3486

NPI assigned

Mar 1, 2006

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

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.

• North Coast Jaw Center. LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • North Olmsted, OH
  • NPI 1255492054
  NPD (past) Authorized official

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1497722268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26777 LORAIN ROAD",
            "address_2": "#600",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703222",
            "telephone_number": "440-734-3131",
            "fax_number": "440-734-3466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26777 LORAIN ROAD",
            "address_2": "#600",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440703222",
            "telephone_number": "440-734-3131",
            "fax_number": "440-734-3486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKEMORE",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30013848",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30.013848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "30013848",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Edward Binder, D.O.
• Bioserenity DT Inc.
• Bioserenity USA, Inc.
• Amber Renee Bizga, D.D.S.
• Tracey Powell Blake, RCP
• William Stephen Blood, D.D.S. MD.
• Blue Ocean Medical Transportation
• Thomas Matthew Bobst, O.D.
• Miranda Boedeker
• Gregory X Boehm, MD

• Oral and Maxillofacial Surgery (Dentist) in North Olmsted, OH
• Providers in North Olmsted, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.