Andrew Nicholas Blackwell, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11-610 Issued in CT

Practice address

387 Main St S
Woodbury, CT 06798-3412

Phone

(203) 263-5300

NPI assigned

Apr 2, 2015

Last updated

Dec 3, 2020By 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 CT

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.

• Blackwell Dental PLLC

  • Dental Clinic/Center
  • Woodbury, CT
  • NPI 1720585680
  NPD Authorized official
• Lance E. Banwell,DDS,PC

  • Dentist
  • Woodbury, CT
  • NPI 1750599270
  NPD (past)

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1801281241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PLEASANT DR",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064883231",
            "telephone_number": "973-627-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 MAIN ST S",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067983412",
            "telephone_number": "203-263-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Hospital Ave",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068106099",
            "country_code": "US",
            "telephone_number": "203-791-5011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "ANDREW",
        "middle_name": "NICHOLAS",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-02",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11-610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael John Berzansky, OD
• Alexandria Bierce
• Birch Psychology LLC
• Alison Birks, LDN
• Blackwell Dental PLLC
• Karen Blomquist, M.D.
• Christine Boampong, BCBA, LBA
• Bourgeois LLC
• William Christopher Brown, LCSW
• Jose Buhain, M.D.

• General Practice Dentistry in Woodbury, CT
• Providers in Woodbury, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.