Heath J. Blake, D.D.S

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

5959068 Issued in UT

Practice address

198 S Main St
Pleasant Grove, UT 84062-2631

Phone

(801) 785-8308

NPI assigned

Mar 27, 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

Enrolled in UT

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

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.

• Blake Dental P.C.

  • Dental Clinic/Center
  • Pleasant Grove, UT
  • NPI 1427364801
  NPD (past) Authorized official

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841318516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 SOUTH MAIN STREET",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "84062",
            "telephone_number": "801-785-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 S MAIN ST",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622631",
            "telephone_number": "801-785-8308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "HEATH",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "UT",
            "license": "5959068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashton Black
• Katherine Nelson Blackham, FNP-C
• Robert Reese Blackhurst, D.D.S.
• Heber James Blackner, LMT
• Blake Dental P.C.
• Jonah Blake
• Brooklyn Blancahrd
• Angie S Bledsoe, MS
• Amelia L Blotter, PA-C
• Marcelle Catherin Bobo

• Public Health Dentistry in Pleasant Grove, UT
• Providers in Pleasant Grove, UT by specialty
• Public Health Dentistry in Utah

• 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.
• 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.