Lawrence David Blake, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS019300-L Issued in PA

Practice address

1745 W Grandview Blvd
Erie, PA 16509-1101

Phone

(814) 868-5197

Fax

(814) 868-3425

NPI assigned

Mar 11, 2007

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

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851423313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5139 RIDGEDALE DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165066115",
            "telephone_number": "814-833-4884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W GRANDVIEW BLVD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165091101",
            "telephone_number": "814-868-5197",
            "fax_number": "814-868-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "LAWRENCE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS019300-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blaine M Bell DMD PC
• Brian David Blair, CRNP
• Markelle Lane Blair, OTR
• Jacob R Blake, PHARMD
• Jeffery Irving Blake, M.D.
• Kirsten Elizabeth Blakeslee, DO
• Ryan David Blanc, DDS
• Evelyn Dianne Blanchard, PT
• Holly Blass, LPC
• Allison Marie Blatt

• General Practice Dentistry in Erie, PA
• Providers in Erie, PA by specialty
• General Practice Dentistry in Pennsylvania

• 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.