NPIMap

Organization Active NPI

Blackwood Family Dentistry

  • Dental Clinic/Center
  • Quinter, KS
National Provider Identifier
1497839013
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
60189 Issued in KS
Legal business name
BLACKWOOD FAMILY DENTISTRY
Practice address
501 Garfield St
Quinter, KS 67752-9795
Phone
(785) 754-2441
Fax
(785) 754-2466
NPI assigned
Oct 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Eric Blackwood, DDSNPI 1487645487
Title
Dentist
Phone
(785) 754-2441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 60189 KS Primary

Addresses

Primary practice location

501 Garfield St
Quinter, KS 67752-9795

Mailing address

PO Box 557
501 Garfield
Quinter, KS 67752-0557
Phone (785) 754-2441

Other identifiers 2

IdentifierTypeStateIssuer
103514OtherKSDORAL LOCATION NUMBER
116736OtherKSBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497839013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 557",
            "address_2": "501 GARFIELD",
            "city": "QUINTER",
            "state": "KS",
            "postal_code": "677520557",
            "telephone_number": "785-754-2441",
            "fax_number": "785-754-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GARFIELD ST",
            "city": "QUINTER",
            "state": "KS",
            "postal_code": "677529795",
            "telephone_number": "785-754-2441",
            "fax_number": "785-754-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKWOOD FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLACKWOOD",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "785-754-2441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "KS",
            "license": "60189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL LOCATION NUMBER",
            "identifier": "103514",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "116736",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quinter, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.