Blake Phillips D.M.D., P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

BLAKE PHILLIPS D.M.D., P.C.

Practice address

1112 19TH St S
Birmingham, AL 35205-4814

Phone

(205) 933-1331

NPI assigned

Oct 10, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joseph Blake Phillips, DMDNPI 1598183204

Title

Oral and Maxillofacial Surgeon

Phone

(205) 933-1332

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Blake Phillips, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Birmingham, AL
  • NPI 1598183204
  Medicare reassignment NPD Authorized official
• William Pettus Buck Jr., DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Birmingham, AL
  • NPI 1982719639
  NPD (past)
• Christopher Michael Rothman, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Birmingham, AL
  • NPI 1578677233
  NPD (past)

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1881236883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352054814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352054814",
            "telephone_number": "205-933-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKE PHILLIPS D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-11-14",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "BLAKE",
        "authorized_official_title_or_position": "ORAL AND MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "205-933-1332",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Blair, NP
• Sarah Faith Blair, CRNP
• Shelby Blair
• Stephen Reagor Blair, MD
• Virginia Blair
• Donaye Allyn Blake, PHARM. D.
• Julie M Blake, O.D.
• Kurt Edson George Blake, MD
• Michelle Antonette Blake
• Pamela J Blake, CRNP

• Oral and Maxillofacial Surgery (Dentist) in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.