Alan Max Blake

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

06008 Issued in IA

Practice address

808 N 9TH St
Estherville, IA 51334-1534

Phone

(712) 362-5454

Fax

(712) 362-4737

NPI assigned

Jan 23, 2007

Last updated

Jul 8, 2007By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Alan M. Blake D.D.S.

  • General Practice Dentistry
  • Estherville, IA
  • NPI 1558694117
  NPD (past) Authorized official
• Courtney S. Meyer, D.D.S., L.L.C.

  • General Practice Dentistry
  • Estherville, IA
  • NPI 1285055350
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831243013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 N 9TH ST",
            "city": "ESTHERVILLE",
            "state": "IA",
            "postal_code": "513341534",
            "telephone_number": "712-362-5454",
            "fax_number": "712-362-4737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 N 9TH ST",
            "city": "ESTHERVILLE",
            "state": "IA",
            "postal_code": "513341534",
            "telephone_number": "712-362-5454",
            "fax_number": "712-362-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "ALAN",
        "middle_name": "MAX",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "06008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avera Holy Family (Avera Holy Family Hospital)
• Avera Home Medical Equipment, LLC
• Nicole Backhaus, RPH
• Merle Craig Baker, O.D.
• Christine Marie Bauermeister, M.S., R.D., L.D.
• Krystine Kay Brashear, ARNP
• Dennis Don Bruns, DDS
• Katie Marie Carter, D.C.
• Champion State of Mind PLLC
• Anthony Ferillo Cook, M.D.

• General Practice Dentistry in Estherville, IA
• Providers in Estherville, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.