BRANDON BLAKE DDS PA (NPI# 1639686736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639686736 |
| Entity Type | Organization |
| Organization Name | BRANDON BLAKE DDS PA |
| Practice Address |
122 Hardees Ln Banner Elk NC 28604-9683 |
| Practice Telephone | 8288984656 |
| Mailing Telephone | 8288984656 |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |
| Authorized Official Name | DR. BRANDON JOSEPH BLAKE (OWNER/DENTIST) |
| Authorized Official Telephone | 8284423206 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
8380 | NC | Ambulatory Health Care Facilities |
| Street Address |
122 HARDEES LN |
| City | BANNER ELK |
| State | NC |
| Zip Code | 28604-9683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245280163 | John Lee Johnson | Dentist | 122 Hardees Ln, Banner Elk, NC 28604-9683 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184194755 | William H Burrow Dds Pllc Dba High Country Dental Associates | Clinic/Center | 2043 Tynecastle Highway, Banner Elk, NC 28604 | 2018-11-27 |
| 1699268953 | Barium Springs Home for Children | Community/Behavioral Health | 158 Grandfather Home Drive Bldg 2, Banner Elk, NC 28604 | 2018-06-12 |
| 1578973996 | Grandfather Home for Children, Inc. | Community Based Residential Treatment Facility, Mental Illness | 158 Grandfather Home Drive, Banner Elk, NC 28604 | 2014-05-07 |
| 1134417314 | Grandfather Home for Children, Inc. | Community Based Residential Treatment Facility, Mental Illness | 233 Grandfather Home Dr., Banner Elk, NC 28604 | 2011-07-21 |
| 1841598745 | Ivan Smith | Pharmacist | 4059 Nc Hwy 105, Rite Aid Pharmacy, Sugar Mountain, NC 28604 | 2011-03-02 |
| 1043515679 | Grandfather Home for Children, Incorporated | Community/Behavioral Health | 64 Grandfather Home Drive, Banner Elk, NC 28604 | 2011-01-12 |
| 1710133012 | Stephanie Knowles | Social Worker | 158 Grandfather Home for Children Way, Hickory Nut Gap Road, Banner Elk, NC 28604 | 2008-08-18 |
| 1235313909 | Dennis Robert Blair | Respiratory Therapist, Registered | 335 Leslie Ln, Banner Elk, NC 28604 | 2007-12-18 |
| 1780867291 | Robert Jones | Spec/Tech, Cardiovascular | 28 Wildcat Creek Lane, Banner Elk, NC 28604 | 2007-12-07 |
| 1730308172 | Erling L Fredrickson | Social Worker | 158 Grandfather Home Way, Hickory Nut Gap Rd., Banner Elk, NC 28604 | 2007-04-24 |
| Find all providers in zip 28604 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184194755 | William H Burrow Dds Pllc Dba High Country Dental Associates | Clinic/Center | 2043 Tynecastle Highway, Banner Elk, NC 28604 | 2018-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1871109041 | Steven D Robertson Dmd, Pa | Clinic/Center | 1613 Montford Dr Ste A, Charlotte, NC 28209-3793 | 2020-09-22 |
| 1477168532 | Caitlin Singleton Dds Pllc | Clinic/Center | 804 Desert Harbor Pl, Cary, NC 27519-9632 | 2020-09-14 |
| 1285243808 | Maja V Martin Dds Pa II | Clinic/Center | 4203 Corners Pkwy, Ste 100, Raleigh, NC 27617 | 2020-07-29 |
| 1265050504 | Hammock, Dmd & Lotakis, Dds X, Pllc | Clinic/Center | 9201 S Tryon St Ste A, Charlotte, NC 28273-4239 | 2020-07-13 |
| 1811514185 | Craig M. Mize Dds, Pa | Clinic/Center | 8300 Falls of Neuse Rd Ste 114, Raleigh, NC 27615-3450 | 2020-07-02 |
| 1730706110 | Maja V Martin, Dds, Pa1 | Clinic/Center | 7371 Six Forks Road, Raleigh, NC 27615 | 2020-07-01 |
| 1194349407 | Michelakis and Associates Pa | Clinic/Center | 1132 New Pointe Blvd Ste 4, Leland, NC 28451-4257 | 2020-06-02 |
| 1427677624 | New Hope Clinic, Inc. | Clinic/Center | 201 W Boiling Spring Rd, Southport, NC 28461-9730 | 2020-04-09 |
| 1699301440 | Tran and Javed Dds Pa | Clinic/Center | 6604 E Marshville Blvd Ste 1, Marshville, NC 28103-1198 | 2020-03-12 |
| Find all providers with the same taxonomy | ||||
| City | BANNER ELK |
| Zip Code | 28604 |
Please comment or provide details below to improve the information on BRANDON BLAKE DDS PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.