Mary Blakeley, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7608 Issued in CO

Practice address

9400 Station St
Suite 175
Lone Tree, CO 80124-6808

Phone

(303) 779-2797

Fax

(303) 779-2687

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Gross Kissinger Former name

Medicare fee-for-service enrollment

Enrolled in CO

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

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.

• Alpha Dental Care V PC

  • Endodontics
  • Lone Tree, CO
  • NPI 1992195267

  General Practice

  NPD (past) Authorized official

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1821184821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 STATION ST",
            "address_2": "SUITE 175",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801246808",
            "telephone_number": "303-779-2797",
            "fax_number": "303-779-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 STATION ST",
            "address_2": "SUITE 175",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801246808",
            "telephone_number": "303-779-2797",
            "fax_number": "303-779-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKELEY",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "7608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KISSINGER",
            "middle_name": "GROSS",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cecilia Suong Billings, OD
• Lindsey Binkley, RN
• Kimberly G Black, M.D.
• Logan Blackney, DO
• Kenneth D Blake, MD
• James M Blatchford, R.PSG.T , CRT
• Ellen R Blatt, M.D.
• Christopher K. Blicharski, M.D.
• Geoffrey Allan Block, MD
• Rebecca Jean Blomquist

• General Practice Dentistry in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.