Active NPI
Charles Blackburn, DDS
- Dentist
- Billings, MT
National Provider Identifier
1801940440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1441
- Practice address
- 123 S 27TH St
Billings, MT 59101-4227 - Phone
- (406) 247-3333
- Fax
- (406) 247-3334
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1441 | MT | Primary |
Addresses
Primary practice location
123 S 27TH St
Billings, MT 59101-4227
Mailing address
123 S 27TH St
Billings, MT 59101-4227
Phone (406) 247-3333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170123001540 | MT | Order and Referring Only - Dentist | 4486936721 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1441 | MT | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482451200000",
"number": "1801940440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 S 27TH ST",
"city": "BILLINGS",
"state": "MT",
"postal_code": "591014227",
"telephone_number": "406-247-3333",
"fax_number": "406-247-3334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 S 27TH ST",
"city": "BILLINGS",
"state": "MT",
"postal_code": "591014227",
"telephone_number": "406-247-3333",
"fax_number": "406-247-3334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "CHARLES",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2016-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MT",
"license": "1441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Billings, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2016; 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.