DR. JASON T BLACKHAM (NPI# 1437132537) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437132537 |
| Entity Type | Individual |
| Full Name | DR. JASON T BLACKHAM |
| Credential | DMD |
| Practice Address |
60 Mdg/sgic 101 Bodin Cir Travis Afb CA 94535-1800 |
| Mailing Address |
101 Bodin Cir Travis Afb CA 94535-1809 |
| Practice Telephone | 7074237083 |
| Practice Fax Number | 7074237117 |
| Mailing Telephone | 7074237083 |
| Mailing Fax Number | 7074237117 |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2020-01-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
264631-9922 | UT | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 417 D Thunderbird Way, Raf Lakenheath, Brandon, Suffolk 279, GB | 01638 533683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821293242 | Jason Lee Blackham | Internal Medicine | 4403 Harrison Blvd, Suite 2400, Ogden, UT 84403-3271 | 2007-06-16 |
| Street Address |
60 MDG/SGIC 101 BODIN CIR |
| City | TRAVIS AFB |
| State | CA |
| Zip Code | 94535-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881696458 | Corey Mark Stanley | Dentist | 60 Mdg/sgic, 101 Bodin Cir, Travis Afb, CA 94535 | 2005-08-12 |
| 1710469432 | Lawrence Patrick Mccarthy | Dentist | 60 Mdg/sgic, Travis Afb, CA 94535-1800 | 2018-08-29 |
| 1871074849 | Sharon Ballinger | Nurse Practitioner | 60 Mdg/sgic, 101 Bodin Cir, Travis Afb, CA 94535-1800 | 2018-08-27 |
| 1821413873 | Shannon Nichole Hewitt | Nurse Practitioner | 60 Mdg/sgic, 101 Bodin Cir, Travis Afb, CA 94535-1800 | 2014-02-27 |
| 1831537158 | Kelly Wails | Social Worker | 60 Mdg/sgic, 101 Bodin Cir, Travis Afb, CA 94535-1800 | 2013-06-08 |
| 1366701831 | Peter B Bell | Anesthesiology | 60 Mdg/sgic, 101 Bodin Cir, Travis Afb, CA 94535 | 2012-05-03 |
| 1760779326 | George Da-chang Hwang | Dentist | 60 Mdg/sgic, Travis Afb, CA 94533 | 2011-07-05 |
| 1972745123 | Wendie S. Li | Internal Medicine | 60 Mdg/sgic, 101 Bodin Cir, Travis Afb, CA 94535-1800 | 2009-04-02 |
| 1518119783 | Enrique A Larin | Physical Therapist | 60 Mdg/sgic, 101 Bodin Cir, Travis Afb, CA 94535 | 2008-10-18 |
| 1144438201 | Steven Lynn Harris | Social Worker | 60 Mdg/sgic, 101 Bodin Cir, Travis Afb, CA 94535-1809 | 2007-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487711 | Sheila C Flood | Student in an Organized Health Care Education/Training Program | 101 Biden Circle, Fairfield, CA 94535 | 2020-04-28 |
| 1568081255 | Miguel Julian Moreno | Student in an Organized Health Care Education/Training Program | 690 Airmen Drive, Travis Afb, CA 94535 | 2020-04-13 |
| 1174096101 | Zlatoslava Karga | Nurse Practitioner | 60mdg / Sgow, 101 Bodin Circle, Travis Afb, CA 94535 | 2019-01-02 |
| 1437648292 | Luke C Vera | Dentist | David Grant Medical Center 101 Bodin Circle, Travis Air Force Base, CA 94535 | 2018-05-08 |
| 1588163430 | Sanaz Ziad | Pharmacist | 60mdg/mdts, 101 Bodin Circle, Travis Afb, CA 94535 | 2018-02-06 |
| 1194265686 | Geoffrey Johnston | Dentist | 60 Mdg/sgdd, 101 Bodin Circle, Travis Afb, CA 94535 | 2017-03-02 |
| 1336693407 | Hannah Isla Nordwall | Social Worker | 60 Mdg/mdos 101 Bodin Cir, Travis Afb, CA 94535 | 2016-08-06 |
| 1184177149 | Taylor Murrie-robinson | Social Worker | 60mdg / Sgow Mental Health Clinic, 101 Bodin Circle, Travis Afb, CA 94535 | 2016-07-26 |
| 1952759607 | Eric Kincaid-sharp | General Practice | 60 Mdg/amds, 101 Bodin Cir, Travis Afb, CA 94535 | 2016-06-02 |
| 1023472040 | Genieve Marie Martinez-hernandez | Internal Medicine | 60 Mdg/sgomi, 101 Bodin Circle, Fairfield, CA 94535 | 2016-04-06 |
| Find all providers in zip 94535 | ||||
| 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 |
|---|---|---|---|---|
| 1811946841 | Michael Gene Neilson | Dentist | 60th Dental Squadron, 101 Bodin Circle, Travis Afb, CA 94535 | 2006-05-08 |
| 1619937067 | Douglas M. Littlefield | Dentist | 60 Mdg/ds, 101 Bodin Cir, Travis Afb, CA 94535-1800 | 2006-03-27 |
| 1568432318 | Christopher Scott Nuttall | Dentist | 60mdg, 101 Bodin Circle, Travis Afb, CA 94535-1800 | 2006-01-25 |
| 1104896125 | Brandon Heath Williams | Dentist | 60 Mdg / 60 Ds 101 Bodin Circle, Travis Afb, CA 94535-1800 | 2006-01-23 |
| 1932183118 | Stephen Bryan Hyslop | Dentist | 151 Bodin Circle, 60th Dental Squadron, Travis Afb, CA 94535-7008 | 2005-12-01 |
| 1578546313 | Steven A Forsythe | Dentist | 60 Mdg/sgd, 101 Bodin Circle, Travis Afb, CA 94535 | 2005-11-25 |
| 1710469432 | Lawrence Patrick Mccarthy | Dentist | 60 Mdg/sgic, Travis Afb, CA 94535-1800 | 2018-08-29 |
| 1770074387 | Elisabeth E Mauro | Dentist | 101 Bodin Cir, Dental Clinic, Travis Afb, CA 94535-1809 | 2018-05-21 |
| 1942738026 | Andrew Anil Jattan | Dentist | 151 Bodin Cir, Travis Afb, CA 94535-1801 | 2017-06-01 |
| 1104252154 | Philip M Worthington | Dentist | 101 Bodin Cir, 60 Mdg/sgdd, Travis Afb, CA 94535-1809 | 2013-09-23 |
| Find all providers in TRAVIS AFB | ||||
| City | TRAVIS AFB |
| Zip Code | 94535 |
Please comment or provide details below to improve the information on DR. JASON T BLACKHAM.
| 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.