Blake Herbison

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00011059 Issued in WA

Practice address

18520 101St Ave NE
Bothell, WA 98011-3804

Phone

(425) 486-2727

NPI assigned

Feb 23, 2010

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

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.

• Blake Herbison DDS PLLC

  • Dentist
  • Bothell, WA
  • NPI 1013191006
  NPD (past) Authorized official

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1689996340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18520 101ST AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18520 101ST AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113804",
            "telephone_number": "425-486-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBISON",
        "first_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-23",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00011059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Hsue & Jennifer Vo PLLC (Annigan Dental)
• Benjamin Patrick Henry, MS, LAT, ATC
• Ashley Hensarling, RD
• Misha Carter Henshaw, MS, RD, CD
• Stella Elizabeth Herbert, LICSW
• Denise Marie Hermans-Smith, L.M.P.
• Ariel Unity Hernandez, MA ED.
• Rachel Cleona Hernandez, RD, LD
• John Arthur Herseth, DDS
• Martha Kelley Hesch, OTR/L

• General Practice Dentistry in Bothell, WA
• Providers in Bothell, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.