Breanne Hafer Bleakmore, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30-023718 Issued in OH

Practice address

4565 Dressler Rd NW
#101
Canton, OH 44718-2549

Phone

(330) 493-9457

NPI assigned

Jul 23, 2012

Sex

Female

Sole proprietor

No

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Breanne Bleakmore DDS LLC

  • Dentist
  • Dublin, OH
  • NPI 1407619463
  NPD Authorized official
• Anthony Codispoti, D.D.S., Stefanie Cain Nikodem, D.D.S., L.L.C.

  • Dentist
  • Canton, OH
  • NPI 1750402251
  NPD (past)

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1982959300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3793 FAIRWAY PARK DR",
            "address_2": "APT 106",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443211674",
            "telephone_number": "937-238-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 DRESSLER RD NW",
            "address_2": "#101",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182549",
            "telephone_number": "330-493-9457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEAKMORE",
        "first_name": "BREANNE",
        "middle_name": "HAFER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-023718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Lynn Blankenship, ATC
• Constance B Blanton, RN
• Mark N Blaser, DO
• Renee Ann Blashak
• Mark Blazel, DO
• Blended Family Health Care Services, LLC
• Blended Family Health Care Services, LLC
• Blended Family Health Care Services, LLC
• Blendedtraditions
• Bleu House Residential

• Dentist in Canton, OH
• Providers in Canton, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.