John P Blake, D.D.S., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16558 Issued in MI

Practice address

1251 S Lapeer Rd
Suite 201
Lake Orion, MI 48360-1414

Phone

(248) 693-5800

Fax

(248) 693-6383

NPI assigned

Oct 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MI

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John P. Blake DDS PC

  • Dental Clinic/Center
  • Lake Orion, MI
  • NPI 1457087934
  NPD Authorized official

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740364199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 S LAPEER RD",
            "address_2": "SUITE 201",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601414",
            "telephone_number": "248-693-5800",
            "fax_number": "248-693-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 S LAPEER RD",
            "address_2": "SUITE 201",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601414",
            "telephone_number": "248-693-5800",
            "fax_number": "248-693-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "16558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hellen Bennett, CNM
• Amanda Marie Berberich, CNM
• Frances T Berg, MA, LPC, NCC
• Beyond Mindful Counseling and Wellness
• Bridget Schultz Bittner, LMSW
• Blossoming Hearts LLC
• Blu Iris Therapeutic Services,LLC
• Lyndsay Bohannon, MA, LLP
• Kerry Bolton
• Rachael Bonin, LMSW

• General Practice Dentistry in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.