Victoria Anne Blackhurst, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

G1-0011512 Issued in DE

Practice address

2710 Centerville Rd Ste 205
Wilmington, DE 19808-1664

Phone

(302) 707-6757

NPI assigned

Jun 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Blackhurst Periodontics, P.a.

  • Periodontics
  • Wilmington, DE
  • NPI 1104751007
  NPD Authorized official

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788739200000",
    "number": "1982198958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 CENTERVILLE RD STE 205",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081664",
            "telephone_number": "302-707-6757",
            "fax_number": "302-707-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 CENTERVILLE RD STE 205",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081664",
            "telephone_number": "302-707-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKHURST",
        "first_name": "VICTORIA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858465",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "DE",
            "license": "G1-0011512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole A Black, CNM
• Tyreka Black
• Don D Blackburn, OD
• Blackhurst Periodontics, P.a.
• Marta Blackhurst, DDS.
• Brenda Blackiston, NP-C
• Tobi Reid Blackiston, DC
• Alicia Blaine, RDN
• John M Blaine, CPRS
• Joan L. Blair, APN

• Periodontics in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Periodontics in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; 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.