Blake Carroll, DDS

Individual provider Active NPI Pediatric Dentistry · Richmond, VA

NPI 1821921750 · NPPES record last updated Jun 8, 2026

Key facts

NPI
1821921750
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Dentistry 1223P0221X
License
0401420090 (VA)
Practice address
1000 E Broad St
Richmond, VA 23219-1930
Phone
(804) 828-9095
NPI assigned
Jun 8, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0401420090 VA Yes

Addresses

Primary practice location

1000 E Broad St
Richmond, VA 23219-1930

Mailing address

2320 Floyd Ave Apt a
Richmond, VA 23220-4408

Other providers in Richmond, VA

All providers in Richmond, VA · Pediatric Dentistry in Virginia

Sources for this page

Verify at the official NPI Registry.