SMILES BY DR. BLACKMON (NPI# 1306260401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306260401 |
| Entity Type | Organization |
| Organization Name | SMILES BY DR. BLACKMON |
| Practice Address |
20119 Van Aken Blvd Ste 211 Shaker Heights OH 44122-3636 |
| Practice Telephone | 2168481420 |
| Practice Fax Number | 2168481400 |
| Mailing Telephone | 2168481420 |
| Mailing Fax Number | 2168481400 |
| Enumeration Date | 2014-02-10 |
| Last Update Date | 2014-02-10 |
| Authorized Official Name | DR. LISA DENISE BLACKMON (OWNER/DENTIST) |
| Authorized Official Telephone | 2168481420 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
30-020813 | OH | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2066580 | 05 |
| Street Address |
20119 VAN AKEN BLVD STE 211 |
| City | SHAKER HEIGHTS |
| State | OH |
| Zip Code | 44122-3636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083174 | Sophia Denise Moncrieffe-jordan | Nurse Practitioner | 23511 Chargin Blvd, Apt. E312, Beachwood, OH 44122 | 2020-11-03 |
| 1447864400 | Resilient Bodies LLC | Massage Therapist | 24300 Chagrin Blvd #312, Beachwood, OH 44122 | 2020-09-06 |
| 1215576087 | Hni Emergency Services of Ohio, LLC | Nurse Practitioner | 22501 Chagrin Blvd, Beachwood, OH 44122 | 2019-12-27 |
| 1013555648 | Barbara L Ekelman Phd Inc | Psychologist | 24100 Chagrin Blvd, Suite 385, Beachwood, OH 44122 | 2019-12-13 |
| 1417599770 | Janise Moore | Technician | 19600 Gladstone Rd, Warrensville Hts, OH 44122 | 2019-10-08 |
| 1598312704 | Nizar Andria | Student in an Organized Health Care Education/Training Program | Cedar Rd 27050, Apartment 515, Beachwood, OH 44122 | 2019-08-22 |
| 1437703998 | Malinda Ann Davis | Social Worker | 20600 Chagrin Blvd Suite 320, Shaker Heights, OH 44122 | 2019-08-01 |
| 1891265864 | Karlan Champagne | Case Management | 23215 Commerence Park, 306, Beachwood, OH 44122 | 2018-12-03 |
| 1952896565 | Donna Pinkney | Counselor | 20550 University Blvd Apt 206, Shaker Hts, OH 44122 | 2018-06-26 |
| 1255825857 | Elizabeth Anne Donathan | Registered Nurse | 4100 Warrensville Center Rd Ste 101, Warrensville Heights, OH 44122 | 2018-06-18 |
| Find all providers in zip 44122 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194972273 | Aspen Dental | Dentist | 15500 Van Aken Blvd, Apt 205, Shaker Heights, OH 44120-5390 | 2008-08-20 |
| 1568571636 | Howard Karfeld | Dentist | 52 Lyman Circle, Shaker Heights, OH 44122-2119 | 2006-08-30 |
| 1235120395 | Mark A Worford | Dentist | 3550 Warrensville Center Rd, 104n, Shaker Heights, OH 44122-5280 | 2005-10-28 |
| 1932553161 | Robert E. Schneider Dds LLC | Dentist | 20620 John Carroll Blvd, Ste 220, Shaker Heights, OH 44118-4539 | 2016-04-13 |
| 1285042010 | Jose Francisco Teppa | Dentist | 16651 Chagrin Blvd, Shaker Heights, OH 44120-3719 | 2014-07-24 |
| 1508161779 | Professional Dental Alliance | Dentist | 12808 Drexmore Rd, Shaker Heights, OH 44120-5609 | 2011-01-20 |
| 1891090064 | Professional Dental Alliance | Dentist | 3729 Lee Rd, Shaker Heights, OH 44120-5103 | 2011-01-20 |
| 1558553842 | Sabrina Eileen Mickel | Dentist | 3461 Warrensville Center Rd, Suite 301, Shaker Heights, OH 44122-5260 | 2007-08-10 |
| 1164560629 | Carol Toutant | Dentist | 20620 N Park Blvd, 218, Shaker Heights, OH 44118-4519 | 2007-02-04 |
| 1063568954 | Robert Edward Schneider | Dentist | 20620 N Park Blvd, Suite 220, Shaker Heights, OH 44118-4519 | 2007-01-25 |
| Find all providers in SHAKER HEIGHTS | ||||
| City | SHAKER HEIGHTS |
| Zip Code | 44122 |
Please comment or provide details below to improve the information on SMILES BY DR. BLACKMON.
| 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.