Neil Blackburn DDS, Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

30015396 Issued in OH

Legal business name

NEIL BLACKBURN DDS, INC.

Practice address

93 E Main St
Amelia, OH 45102-1948

Phone

(513) 753-7199

Fax

(513) 753-8843

NPI assigned

Sep 15, 2015

Organization subpart

No

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

Authorized official

Name

Cheryl Blackburn

Title

Office Manager

Phone

(513) 753-7199

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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

• Neil Blackburn, DDS

  • General Practice Dentistry
  • Amelia, OH
  • NPI 1316054182
  NPD (past)
• Vaughn Daniel Blackburn, DPM

  • Podiatrist
  • Amelia, OH
  • NPI 1386925170
  NPD (past)

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1508234030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 E MAIN ST",
            "city": "AMELIA",
            "state": "OH",
            "postal_code": "451021948",
            "telephone_number": "513-753-7199",
            "fax_number": "513-753-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 E MAIN ST",
            "city": "AMELIA",
            "state": "OH",
            "postal_code": "451021948",
            "telephone_number": "513-753-7199",
            "fax_number": "513-753-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIL BLACKBURN DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "513-753-7199"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30015396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0387442",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Amelia, OH
• Providers in Amelia, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.