Blake Jude Vidrine II, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7227 Issued in LA

Practice address

10330 Airline Hwy Ste A6
Baton Rouge, LA 70816-4191

Phone

(225) 308-8000

Fax

(225) 308-8000

NPI assigned

May 29, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Louisiana Implants and Dentures

  • General Practice Dentistry
  • Baton Rouge, LA
  • NPI 1619751427
  NPD Authorized official
• Mission Dental Mobile LLC

  dba Miles of Smiles

  • Dentist
  • Bessemer, AL
  • NPI 1205694932
  NPD (past)

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

{
    "created_epoch": "1622246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1841866969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 CYPRESS DR",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705262008",
            "telephone_number": "337-581-5791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10330 AIRLINE HWY STE A6",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164191",
            "telephone_number": "225-308-8000",
            "fax_number": "225-308-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRINE",
        "first_name": "BLAKE",
        "middle_name": "JUDE",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-29",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D-0006879-C1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victory Health Solutions, LLC
• Victory Physical Therapy & Rehab Clinic
• Tamajiea Videau, RSW
• Vidrine Psychiatry LLC
• Ashton C Vidrine, APRN, PMHNP-BC, LMSW
• Kirk Vidrine, RDN, LDN
• Margaret Rose Vidrine, MD
• Lauren Vienne
• Vilas & Company LLC
• Norakate 'Kathy' R. Vilas, LCSW

• General Practice Dentistry in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.