DR. THOMAS R BLAKE


Address: 2409 Fairoak Dr, Fort Wayne, IN 46809-2301
Phone: 2607475745

DR. THOMAS R BLAKE (NPI# 1669517330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1669517330
Entity Type Individual
Full Name DR. THOMAS R BLAKE
Credential DDS
Practice Address 2409 Fairoak Dr
Fort Wayne
IN 46809-2301
Practice Telephone 2607475745
Mailing Telephone 2607475745
Enumeration Date 2007-02-21
Last Update Date 2007-07-09
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
7973 IN Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN UNITED CONCORDIA 777279 01
IN PHP 1091 01

Other Providers THOMAS BLAKE

NPI Name Taxonomy Address Enumeration
1659911428 Thomas James Blake Social Worker Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 2020-01-09
1932228111 Thomas M. Blake Dentist 15 E Arrellaga St Ste 3, Santa Barbara, CA 93101-2531 2007-03-28
1992862593 Thomas Joel Blake Dentist 721 N Pines Rd, Suite 101, Spokane Valley, WA 99206-5225 2007-01-02
1013075746 Thomas Leon Blake Chiropractor 104 North Greensboro Street, Liberty, NC 27298-3203 2006-12-05
1063597847 Thomas Lee Blake Optometrist 11847 South St, Cerritos, CA 90703-6825 2006-10-27
1952493991 Thomas T Blake Jr. Chiropractor 4715 Sunset Blvd Ste C, Lexington, SC 29072-9151 2006-09-28
1558330415 Thomas Harold Blake Jr. Orthopaedic Surgery 424 S 13th Ave, Laurel, MS 39440-4345 2006-03-14
1508873787 Thomas B Blake IIi Specialist 331 N Maitland Ave, Suite A-2, Maitland, FL 32751-4762 2006-08-01
1528025012 Thomas Duvall Blake Family Medicine 7255 Hanover Green Dr, Mechanicsville, VA 23111-1706 2006-04-27

Office Location

Street Address 2409 FAIROAK DR
City FORT WAYNE
State IN
Zip Code 46809-2301

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1497038574 Zachary L Roberts Pharmacist 12279 Bluffton Road, Fort Wayne, IN 46809 2011-09-24
1679660278 Kool Smiles In Ft. Wayne, PC Dentist 1852 Bluffton Road, Ft. Wayne, IN 46809 2006-10-06
1477512564 Brian Thomas Raypole Specialist/Technologist 5050 N. Clinton Street, Fort Wayne, IN 46809 2006-03-20
1669016895 Trinity Health Pharmacy Services, LLC Pharmacy 12279 Bluffton Road, Fort Wayne, IN 46809 2019-10-31
1871049981 Mark Sexton Physical Therapist 3534 Brooklyn Ave, Fort Wayne, IN 46809 2016-08-29
1841573318 Vicki Eileen Caccamo Pharmacist 6730 Bluffton Rd, Fort Wayne, IN 46809 2011-09-21
1104988112 Karena Diane Schroeder Physical Therapist 3534 Brooklyn Ave, Fort Wayne, IN 46809 2006-12-15
1013084946 David L Kuhn Physical Therapist 3534 Brooklyn Ave, Fort Wayne, IN 46809 2006-11-29
1265588404 May R. Dahman Specialist 1733 Kinsmoor Ave, Fort Wayne, IN 46809-1025 2007-01-27
1134746209 Laurel Schroeder Occupational Therapist 1726 Bluffton Rd, Fort Wayne, IN 46809-1305 2020-07-06
Find all providers in zip 46809

Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Notes: Source: Academy of General Dentistry

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679186258 James Patrick Thompson Dentist 5909 Wheelock Rd Ste 102, Fort Wayne, IN 46835-9258 2020-08-25
1295357481 Sycamore Hills Dentistry Dentist 10082 Illinois Rd, Fort Wayne, IN 46804-5772 2020-05-11
1699324103 Phillip M. Mckean Professional Corporation Dentist 6605 E State Blvd Ste 7, Fort Wayne, IN 46815-7036 2019-09-06
1598322083 Charles Chase Ellinwood Dentist 5725 Maplecrest Rd Ste 1, Fort Wayne, IN 46835-4937 2019-05-21
1689140949 Harrison Dental Group II, LLC Dentist 1333 Getz Rd, Fort Wayne, IN 46804 2018-10-15
1821582172 Jacob Yager Dentist 9830 Auburn Rd Ste 101, Fort Wayne, IN 46825-2464 2018-06-20
1740772656 Colleen Rose Allen Dentist 10213 Dupont Circle Dr W, Fort Wayne, IN 46825-1656 2018-06-06
1407360910 Grace Xinxing Clark Dentist 4716 Illinois Rd Ste 101, Fort Wayne, IN 46804-5123 2017-11-20
1578959375 Ronald L Rumbaugh Dds PC Dentist 10506 Coldwater Rd, Fort Wayne, IN 46845-1235 2015-04-09
1619388063 Familia Dental Spfw Pllc Dentist 100 E Pettit Ave, 1a, Fort Wayne, IN 46806-3003 2014-05-19
Find all providers in FORT WAYNE

Competitor

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City FORT WAYNE
Zip Code 46809

Improve Information

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Dataset Information

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.

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