Brian E. Blackwell, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13259 Issued in MN

Practice address

2145 Woodlane Dr Ste 104
Saint Paul, MN 55125-1920

Phone

(651) 738-8204

NPI assigned

Feb 17, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Bbccs PLLC

  • General Practice Dentistry
  • Woodbury, MN
  • NPI 1073327995
  NPD Authorized official
• Creekview Dental PA

  • Dentist
  • Woodbury, MN
  • NPI 1861463465
  NPD (past)
• Yellowstone Family Dental

  • General Practice Dentistry
  • Billings, MT
  • NPI 1437434123
  NPD (past)

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

{
    "created_epoch": "1361059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745107200000",
    "number": "1669712303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 WOODLANE DR STE 104",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551251920",
            "telephone_number": "651-738-8204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 WOODLANE DR STE 104",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551251920",
            "telephone_number": "651-738-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "BRIAN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-17",
        "last_updated": "2025-04-20",
        "certification_date": "2025-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Black Legacy Group LLC
• James E Black, M.D.
• Meghan T Black, DDS
• Sharon Black, PHD, LP
• Monty Blackberg
• Rebecca Lynn Blackwell
• Alisa Blackwood, CD(DONA)
• Garrett Franklin Blaha, RN
• Haley Anne Blahnik, PA-C
• Annika Lee Blaine

• General Practice Dentistry in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2025; 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.