Randall Todd Blincoe, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

6432 Issued in KY

Practice address

12 Orphanage Rd
Fort Mitchell, KY 41017-3072

Phone

(859) 331-1960

Fax

(859) 331-2257

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1508988205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ORPHANAGE RD",
            "city": "FORT MITCHELL",
            "state": "KY",
            "postal_code": "410173072",
            "telephone_number": "859-331-1960",
            "fax_number": "859-331-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ORPHANAGE RD",
            "city": "FORT MITCHELL",
            "state": "KY",
            "postal_code": "410173072",
            "telephone_number": "859-331-1960",
            "fax_number": "859-331-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLINCOE",
        "first_name": "RANDALL",
        "middle_name": "TODD",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "6432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Samantha Ann Blanke, OD
• Jeffrey J Blau, MD
• Jennifer Blincoe, DMD
• Tyler Blincoe, DMD
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• Mary Elizabeth Bolger, OTRL
• Bolte Psychological Services, LLC

• All providers in Fort Mitchell, KY
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.