James Edward Blank, DDS
Individual provider Active NPI General Practice Dentistry · Powell, OH
NPI 1992892533 · NPPES record last updated Oct 14, 2019
Key facts
- NPI
- 1992892533
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 30-022073 (OH)
- Practice address
- 9733 Sawmill Pkwy
Powell, OH 43065-6101 - Phone
- (614) 764-1013
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 21, 2015 through Sep 21, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30022073 | OH | MD | Dentist |
| 30-022073 | OH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blank Dental Management Co, LLC | General Practice | Current | Accepting new patients |
| Ohio Dental Professionals, Delisle, P.C. | General Practice | Past |
Accepting new patients |
Locations
200 N Fountain Ave
Springfield, OH 45504
Phone (937) 399-9381
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 30022073 | OH | |
| General Practice Dentistry | 1223G0001X | 30-022073 | OH | Yes |
Addresses
Primary practice location
9733 Sawmill Pkwy
Powell, OH 43065-6101
Mailing address
7120 Deacon CT
Dublin, OH 43017-7078
Phone (614) 595-1140
Other practice location 1
5491 Scioto Darby Rd Ste 100
Hilliard, OH 43026-1569
Phone (614) 876-4900
Other practice location 2
1271 E Broad St
Columbus, OH 43205-1429
Phone (614) 252-4444
Other practice location 3
200 N Fountain Ave
Springfield, OH 45504-2535
Phone (937) 399-9381
Other providers in Powell, OH
- Stacey Leigh Biffle-Quimba
- Christopher R Birr
- Rachelle Blake
- Lori Blakely
- Blank Dental Management Co, LLC
- Timothy Paul Blecke
- Mindy Jo Blevins
- Reza Bolourian
- Boudreau Counseling Services
- Kristen Leigh Boudreau
All providers in Powell, OH · General Practice Dentistry in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.