David Paul Blackburn, DMD, MSD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2015012810 Issued in MO

Practice address

3131 S State Route 291 Ste a
Independence, MO 64057-2657

Phone

(816) 373-6006

Fax

(816) 373-1840

NPI assigned

Sep 10, 2007

Last updated

Feb 19, 2025By 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

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": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1942495320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 S. STATE ROUTE 291",
            "address_2": "SUITE A",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "64057",
            "telephone_number": "816-373-6006",
            "fax_number": "816-373-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 S STATE ROUTE 291 STE A",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572657",
            "telephone_number": "816-373-6006",
            "fax_number": "816-373-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-10",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "2015012810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Birenboim, M.D.
• Cameron Anttwan Birmingham
• Tobie Lynne Bisges, MPAS, PA-C
• Aubrey Bittel
• David A Black, D.C.
• Kari Blaeuer, SLP
• Dalen Grey Blair, PT, DPT
• Amauri Nichole Blake
• Sargine Blake
• Cindy L Blakemore

• Orthodontics and Dentofacial Orthopedics Dentistry in Independence, MO
• Providers in Independence, MO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.