Alonzo Carlos Blackmon, D.D.S, M.S.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN23627 Issued in FL

Practice address

153 Fort Wade Rd Ste 100
Ponte Vedra, FL 32081-5205

Phone

(904) 395-5501

NPI assigned

Aug 26, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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 and National Provider Directory roles.

• Guided Smiles Prosthodontics & Implant Center PLLC

  • Dental Clinic/Center
  • Ponte Vedra, FL
  • NPI 1114641339
  NPD Authorized official

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1821422908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 FORT WADE RD STE 100",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815205",
            "telephone_number": "904-395-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 FORT WADE RD STE 100",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815205",
            "telephone_number": "904-395-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "ALONZO",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-26",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414082",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN23627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rochelle Bardis, APRN
• Amanda Bartell, D.P.M.
• Beaches Education & Counseling
• Bella Cesca International, LLC
• Rebecca Bertone, APRN
• Blue Water Dental of St. Johns
• Blue Water Health and Wellness LLC
• Bluebird Medical & Wellness Corp
• Bluebird Pediatrics
• Bluewater Wellness Center

• Prosthodontics in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Prosthodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; 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.