BLAKE HARRISON MULGREW (NPI# 1972901619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972901619 |
| Entity Type | Individual |
| Full Name | BLAKE HARRISON MULGREW |
| Credential | DMD |
| Practice Address |
1941 Interstate 35 Frontage Road San Marcos TX 78666 |
| Mailing Address |
1300 E Riverside Dr Apt D411 Austin TX 78741-1213 |
| Practice Telephone | 5123926222 |
| Mailing Telephone | 5209904684 |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2014-12-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 30602 | TX | Dental Providers |
| Street Address |
1941 INTERSTATE 35 FRONTAGE ROAD |
| City | SAN MARCOS |
| State | TX |
| Zip Code | 78666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656198 | Jodie Lynn Stauffer | Social Worker | 2497 Fm 1979, San Marcos, TX 78666 | 2020-10-14 |
| 1619590965 | Ann Mary Carney | Occupational Therapist | 302 Riverside Dr, San Marcos, TX 78666 | 2020-05-21 |
| 1811510381 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 101 Concho St, San Marcos, TX 78666 | 2020-05-19 |
| 1174157101 | Chase Joseph Gibson | Specialist/Technologist | 616 N Lbj Dr, Beretta Hall 401, San Marcos, TX 78666 | 2020-02-28 |
| 1548800782 | Emily Granger | Specialist/Technologist | 106 Charles Austin Dr, San Marcos, TX 78666 | 2020-01-15 |
| 1689138562 | Joseph Richard Lednicky | Specialist/Technologist | 700 Aquarena Springs Drive, San Marcos, TX 78666 | 2019-01-25 |
| 1376007336 | Viktoria Guerrero | Specialist/Technologist | Jowers Access Rd, San Marcos, TX 78666 | 2019-01-24 |
| 1336611771 | Joan Marie Wood | Occupational Therapist | Cole Pediatric Therapy, 101 Uhland Rd, San Marcos, TX 78666 | 2018-12-26 |
| 1851861496 | Kingfisher Health LLC | Home Health | 125 Mccarty Lane, San Marcos, TX 78666 | 2018-11-27 |
| 1669954723 | Christopher Macha | Student in an Organized Health Care Education/Training Program | 1 Jowers Access Road, San Marcos, TX 78666 | 2018-09-05 |
| Find all providers in zip 78666 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457878415 | Smile Community Clinic Inc | Dentist | 670 W. San Marcos Blvd. Ste 103-b, San Marcos, CA 92078 | 2017-08-29 |
| 1164977047 | Sarah Marie Severson | Dentist | 1890 Medical Pkwy, San Marcos, TX 78666-7998 | 2016-08-19 |
| 1376941179 | Amir Pasha Farnaghi | Dentist | 1920 Corporate Dr Ste A107, San Marcos, TX 78666-6282 | 2014-12-09 |
| 1558774570 | Jerry Westover | Dentist | 651 Barnes Dr Ste 205, San Marcos, TX 78666-6225 | 2014-06-06 |
| 1114293149 | Western Dental Services, Inc. | Dentist | 169 S Rancho Santa Fe Rd, San Marcos, CA 92078-2501 | 2012-03-23 |
| 1811276983 | Karina A Gregg | Dentist | 1691 Melrose Dr, Suite 160, San Marcos, CA 92078-2127 | 2011-08-08 |
| 1629386065 | Rafael Garcia | Dentist | 1941 S Ih 35 Ste 107, San Marcos, TX 78666-6169 | 2010-09-20 |
| 1285949388 | Alfredo Ortiz Jr. | Dentist | 301 W Hopkins St, San Marcos, TX 78666-4403 | 2010-08-12 |
| 1144532672 | Vida Namavar | Dentist | 670 W San Marcos Blvd, Ste 103, San Marcos, CA 92078-1235 | 2010-07-13 |
| 1780830687 | Brandon Boekamp Fowler | Dentist | 1231 Elfin Forest Rd W, Suite 200, San Marcos, CA 92078-2045 | 2008-08-11 |
| Find all providers in SAN MARCOS | ||||
| City | SAN MARCOS |
| Zip Code | 78666 |
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| 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.