DR. DAVID CROCKETT BLYTHE JR. (NPI# 1730249541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730249541 |
| Entity Type | Individual |
| Full Name | DR. DAVID CROCKETT BLYTHE JR. |
| Credential | DDS |
| Practice Address |
401 Liberty St Houma LA 70360-4617 |
| Practice Telephone | 9858513710 |
| Practice Fax Number | 9858513711 |
| Mailing Telephone | 9858513710 |
| Mailing Fax Number | 9858513711 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2345 | LA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1823457 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477893188 | David Blythe | Preventive Medicine | 201 W Preston St, Baltimore, MD 21201-2301 | 2013-02-18 |
| 1821380742 | David S Blythe | Pharmacist | 3300 Cottman Ave, Philadelphia, PA 19149-1601 | 2011-05-11 |
| Street Address |
401 LIBERTY ST |
| City | HOUMA |
| State | LA |
| Zip Code | 70360-4617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285171 | Sportsman's Paradise Surgical Assistants | Physician Assistant | 401 Liberty St, Houma, LA 70360-4617 | 2020-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382697 | Start Corporation | Clinic/Center | 106 School Street, Houma, LA 70360 | 2020-09-24 |
| 1013474196 | Christi Thibodeaux Rodrigue | Case Manager/Care Coordinator | 427west Tunnel Blvd, Houma, LA 70360 | 2019-02-26 |
| 1053801415 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1420 Saint Charles St, Houma, LA 70360 | 2018-05-11 |
| 1447780044 | Shakira Harding | Counselor | 148 Columbus Street, Houma, LA 70360 | 2017-06-15 |
| 1639608995 | Rakitha Monique Volter-jones | Counselor | 6522 West Main Street, Houma, LA 70360 | 2017-06-08 |
| 1588103469 | Eyecare Specialties | Ophthalmology | 564 Valhi Blvd, Houma, LA 70360 | 2017-02-13 |
| 1538605464 | Houma Dental Associates, LLC | Dentist | 5934 West Main St, Houma, LA 70360 | 2017-01-17 |
| 1649721143 | Bio-medical Applications of Louisiana, LLC | Clinic/Center | 143 War Horse Place, Houma, LA 70360 | 2016-10-19 |
| 1528417045 | Mandi Gaubert Bonvillain | Psychologist | 1018 Verrett Street, Houma, LA 70360 | 2016-06-06 |
| 1295182434 | Kerry M Guidry | Chiropractor | 6902 West Main Street, Houma, LA 70360 | 2016-05-18 |
| Find all providers in zip 70360 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275538191 | David Gunter Baughman | Dentist | 1608 Polk St, Houma, LA 70360-6011 | 2005-06-16 |
| 1629267075 | Oral-facial Surgery Center Apc | Dentist | 1608 Polk St, Houma, LA 70360-6011 | 2007-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1578089603 | Ardoin-kennedy LLC | Dentist | 203 A Energy Parkway, Lafayette, LA 70508 | 2017-08-21 |
| 1932583358 | Oral Surgery& Dental Implant Center of Louisiana | Dentist | 16206 Airline Hwy, Prairieville, LA 70769-4248 | 2015-07-15 |
| 1588078224 | Ricardo Lugo | Dentist | 1501 Kings Hwy Rm 530, Shreveport, LA 71103-4228 | 2014-06-19 |
| 1184059818 | Yasser Saad Alali | Dentist | 5243 Butter Creek, Unit H7, Baton Rouge, LA 70809-0603 | 2013-09-12 |
| 1679913222 | Nickolas Stanley Maskas | Dentist | 4720 Lake Street, Lake Charles, LA 70605 | 2013-06-27 |
| 1720354822 | John Ben Ragusa | Dentist | 16819 Cherry Bark Dr, Baton Rouge, LA 70810-5811 | 2012-03-22 |
| 1871882480 | Andrew Frederick Wetterlind | Dentist | 13730 Millerville Greens Blvd, Baton Rouge, LA 70816-1696 | 2011-04-04 |
| 1932415007 | Dr. David M. Vieth Dds, A Professional Corporation | Dentist | 91 Westbank Expy, Suite 345, Gretna, LA 70053-3615 | 2010-08-26 |
| 1871757187 | George Rawleigh Fisher | Dentist | 1624 Wolf Cir, Lake Charles, LA 70605 | 2008-07-16 |
| Find all providers with the same taxonomy | ||||
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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.