Peter J Blank, D.D.S.

Individual provider Active NPI General Practice Dentistry · Hebron, IN

NPI 1912902883 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1912902883
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
12009167 (IN)
Practice address
192 Professional CT
Hebron, IN 46341-8948
Phone
(219) 996-5606
Fax
(219) 996-5601
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
12009167INMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12009167 IN Yes

Addresses

Primary practice location

192 Professional CT
Hebron, IN 46341-8948

Mailing address

192 Professional CT
Hebron, IN 46341-8948
Phone (219) 996-5606

Other providers in Hebron, IN

All providers in Hebron, IN · General Practice Dentistry in Indiana

Sources for this page

Verify at the official NPI Registry.