CHARLTON BRYAN BLAKENEY D.M.D. (NPI# 1417352204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417352204 |
| Entity Type | Organization |
| Organization Name | CHARLTON BRYAN BLAKENEY D.M.D. |
| Practice Address |
12182 Highway 49 Gulfport MS 39503-3125 |
| Practice Telephone | 2288324224 |
| Practice Fax Number | 2288324896 |
| Mailing Telephone | 2288324224 |
| Mailing Fax Number | 2288324896 |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |
| Authorized Official Name | KAREN BLAKENEY (OWNER) |
| Authorized Official Telephone | 2288960019 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
12182 HIGHWAY 49 |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-3125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659864544 | Steven Parker Blakeney | Dentist | 12182 Highway 49, Gulfport, MS 39503-3125 | 2018-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| Find all providers in zip 39503 | ||||
| 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 |
|---|---|---|---|---|
| 1932706306 | Brenyatta Travis | Dentist | 28 Pass Rd Ste 300, Gulfport, MS 39507-3244 | 2020-10-07 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1477086585 | Jason Franklin Olaivar | Dentist | 1311 Beards Cove, Gulfport, MS 39507-3600 | 2017-04-05 |
| 1700131331 | Anna Rose Snyder Rider | Dentist | 410 Security Sq, Gulfport, MS 39507-1952 | 2012-07-19 |
| 1174829501 | Kinyatta Bennett | Dentist | 13179 Three Rivers Rd, Gulfport, MS 39503-4944 | 2011-02-02 |
| 1033412176 | Toothdocs, LLC | Dentist | 382 Courthouse Rd, Suite B, Gulfport, MS 39507-1863 | 2010-12-13 |
| 1891985875 | Mike C Mccabe | Dentist | 605 16th St, Gulfport, MS 39507-1302 | 2007-07-26 |
| 1376765016 | David Ricardo Mendoza | Dentist | 5028 Gulfport Blvd S, Gulfport, FL 33707-4942 | 2007-05-03 |
| 1104957422 | Hillcrest Dental Group, P.a. | Dentist | 382 Courthouse Rd Ste B, Gulfport, MS 39507-1864 | 2007-03-08 |
| 1639213275 | Edward S. Wheeler, Dmd, Pa | Dentist | 14120 Dedeaux Rd, Gulfport, MS 39503-4527 | 2007-02-16 |
| Find all providers in GULFPORT | ||||
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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.