J BLAKE, DMD, PS (NPI# 1255531018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255531018 |
| Entity Type | Organization |
| Organization Name | J BLAKE, DMD, PS |
| Other Organization Name | KIDSMILE DENTAL |
| Practice Address |
12615 E Mission Ave Suite 312 Spokane Valley WA 99216-1047 |
| Practice Telephone | 5099261234 |
| Practice Fax Number | 5099261701 |
| Mailing Telephone | 5099261234 |
| Mailing Fax Number | 5099261701 |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2009-03-31 |
| Authorized Official Name | DR. T. JOEL BLAKE (OWNER/DENTIST) |
| Authorized Official Telephone | 5099261234 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
10588 | WA | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
9846 | WA | Dental Providers |
| Other Name | Type Code |
|---|---|
| KidSmile Dental | Doing Business As Name - Organization |
| Street Address |
12615 E MISSION AVE SUITE 312 |
| City | SPOKANE VALLEY |
| State | WA |
| Zip Code | 99216-1047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710988746 | Robert J Golden | General Practice | 12615 E Mission Ave, Ste 303, Spokane Valley, WA 99216-1047 | 2005-08-01 |
| 1952882078 | Marilyn Louise Smith | Health Educator | 12615 E Mission Ave, Spokane Valley, WA 99216 | 2018-08-27 |
| 1003352410 | Kai Morimoto Md Pllc | Plastic Surgery | 12615 E Mission Ave, Suite 105, Spokane Valley, WA 99216-3060 | 2017-01-09 |
| 1962950493 | Acuhealth Solutions LLC | Acupuncturist | 12615 E Mission Ave, Suite 101, Spokane Valley, WA 99216-3060 | 2016-09-13 |
| 1932332541 | Molly Jean Blaylock | Massage Therapist | 12615 E Mission Ave, Suite 400, Spokane Valley, WA 99216-3060 | 2009-08-29 |
| 1588810659 | Lake City Physical Therapy,pa | Physical Therapist | 12615 E Mission Ave, Suite 109, Spokane Valley, WA 99216-1047 | 2008-08-08 |
| 1417086976 | Alyssa Marie Jordan | Massage Therapist | 12615 E Mission Ave, Suite 400, Spokane Valley, WA 99216-1047 | 2007-03-02 |
| 1124168323 | Kevin Joseph Lucas | Massage Therapist | 12615 E Mission Ave, Suite 400, Spokane Valley, WA 99216-1047 | 2007-02-07 |
| 1790831782 | Pramod Sinha Dds Ms | Dentist | 12615 E Mission Ave, Suite 110, Spokane Valley, WA 99216-1047 | 2007-01-25 |
| 1104983709 | Dale R Ruemping | Dentist | 12615 E Mission Ave, Suite 312, Spokane Valley, WA 99216-1047 | 2007-01-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053920124 | Aark Laboratory | Clinical Medical Laboratory | 12709 E Mirabeau Pkwy Bldg A Ste 500, Spokane, WA 99216 | 2020-07-24 |
| 1922622158 | Vera Whole Health Wa, PC | Clinic/Center | 16009 E Indiana Ave, Spokane Valley, WA 99216 | 2020-06-03 |
| 1023654001 | Rebecca Elizabeth Ryan | Massage Therapist | 12505 E 23rd Ave, Spokane Valley, WA 99216 | 2019-11-25 |
| 1356992903 | Creative Communication LLC | Speech-Language Pathologist | 13607 E. Sprague Ave, Spokane Valley, WA 99216 | 2019-09-25 |
| 1972096584 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 15319 E Indiana Ave Ste 2, Spokane Valley, WA 99216 | 2018-06-08 |
| 1356845655 | Rp Operations, LLC | Assisted Living Facility | 13013 E Mission Ave, Spokane Valley, WA 99216 | 2018-03-21 |
| 1174036305 | Talk, Learn and Communicate | Speech-Language Pathologist | 13607 East Spraque Avenue, Spokane Valley, WA 99216 | 2017-11-09 |
| 1134638281 | Vtc Vitality Healthcare | Pain Medicine | 12409 E Mission Ave Ste 102, Spokane Valley, WA 99216 | 2017-09-20 |
| 1285150086 | Robert C Tsay Jr. | Pharmacist | 12415 E 12th Ave, Apt 110, Spokane Valley, WA 99216 | 2017-08-15 |
| 1629505607 | Spokane Valley Medical, Inc | Durable Medical Equipment & Medical Supplies | 12509 E. Mission Ave, Suite #103, Spokane, WA 99216 | 2017-05-22 |
| Find all providers in zip 99216 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609194935 | Molly Gunsaulis, Dds Dentistry for Children | Dentist | 15404 E Springfield Ave Ste 102, Spokane Valley, WA 99037-8569 | 2010-05-11 |
| 1285840256 | Molly A. Gunsaulis | Dentist | 15404 E Springfield Ave, 102, Spokane Valley, WA 99037 | 2007-05-15 |
| 1104983709 | Dale R Ruemping | Dentist | 12615 E Mission Ave, Suite 312, Spokane Valley, WA 99216-1047 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740807890 | Plateau Kids Dentistry, LLC | Dentist | 2912 228th Ave Se Ste A, Sammamish, WA 98075-9305 | 2020-07-05 |
| 1528603503 | Ellen Polsky Dds and Bobby Virk Dmd, Ps | Dentist | 34704 11th Pl S Ste 101, Federal Way, WA 98003-8730 | 2019-11-13 |
| 1942843552 | Laura Stewart Dds Pllc | Dentist | 6821 Ne 181st St, Kenmore, WA 98028-5034 | 2019-10-26 |
| 1639736119 | Southcenter Children's Dentistry | Dentist | 411 Strander Blvd Ste 303, Tukwila, WA 98188-2924 | 2019-05-21 |
| 1770147001 | Kaitlin Neste Pllc | Dentist | 360 Tormey Ln Ne Ste 198, Bainbridge Island, WA 98110-1990 | 2019-04-22 |
| 1124511126 | Roger Lucas, P.s. | Dentist | 3806 116th St. Ne, Marysville, WA 98271 | 2018-06-13 |
| 1497248017 | Jinju Song Dmd Pllc | Dentist | 9707 Ne 119th Way, Kirkland, WA 98034-8955 | 2018-06-08 |
| 1861999864 | Peter Douglas | Dentist | 32105 1st Ave S Ste B3, Federal Way, WA 98003-5719 | 2018-04-07 |
| 1669994042 | Annikka Louise Frostad-thomas | Dentist | 700 Nw Gilman Blvd # E412, Issaquah, WA 98027-5395 | 2017-07-07 |
| 1831624402 | Minh Dau, Dds and Raymond Park, Dds Pllc | Dentist | 3105 Alderwood Mall Blvd, Suite 117, Lynnwood, WA 98036-4703 | 2017-04-20 |
| Find all providers with the same taxonomy | ||||
| City | SPOKANE VALLEY |
| Zip Code | 99216 |
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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.