Blaine D. Austin DDS Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

140958 Issued in UT

Legal business name

BLAINE D. AUSTIN DDS INC.

Doing business as

Dr. Blaine D. Austin DDS

Practice address

1250 East 3900 South
Suite 210
Salt Lake City, UT 84124

Phone

(801) 264-1500

Fax

(801) 265-9963

NPI assigned

Dec 19, 2017

Organization subpart

No

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

Authorized official

Name

Blaine D Austin, DDS

Title

Oral Maxillo-Facial Surgery

Phone

(801) 759-4378

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Blaine D. Austin DDS Doing business as

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1679089239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 210",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241367",
            "telephone_number": "801-265-1500",
            "fax_number": "801-259-9963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 EAST 3900 SOUTH",
            "address_2": "SUITE 210",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84124",
            "telephone_number": "801-264-1500",
            "fax_number": "801-265-9963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAINE D. AUSTIN DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "BLAINE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ORAL MAXILLO-FACIAL SURGERY",
        "authorized_official_telephone_number": "801-759-4378",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "140958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "U000005310",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Blaine D. Austin DDS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr. Blaine D. Austin DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Blackstone Dental PLLC
• Augusta Blackstone
• Clinton T Blackwood, D.D.S.
• Cheri Danielle Blades, M.S., CCC-SLP
• Michael Blain, PHARM. D
• Catherine Blaine
• Brandon Blair, NCTMB
• Felisha Kiyomi Blair
• Gary Dean Blair
• Jaycee Blair, PHARMD

• Oral and Maxillofacial Surgery (Dentist) in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; 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.