DR. BLAKE WILLIAM SCOTT (NPI# 1972714707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972714707 |
| Entity Type | Individual |
| Full Name | DR. BLAKE WILLIAM SCOTT |
| Credential | D.D.S. |
| Practice Address |
13128 14th St First Dental Battalion Ndc Camp Pendleton CA 92055 |
| Mailing Address |
6333 La Jolla Blvd Unit 271 La Jolla CA 92037-6615 |
| Practice Telephone | 7607255578 |
| Mailing Telephone | 4155176729 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730675752 | Blake Scott | Specialist | 5050 Madison Rd, Cincinnati, OH 45227-1491 | 2018-07-02 |
| 1962645929 | Blake K Scott | Internal Medicine | 1901 S Hawthorne Rd, Suite 310, Winston Salem, NC 27103-3921 | 2009-04-07 |
| Street Address |
13128 14TH ST FIRST DENTAL BATTALION NDC |
| City | CAMP PENDLETON |
| State | CA |
| Zip Code | 92055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336131804 | Marta Walchessen Tanaka | Dentist | 13128 14th St, Camp Pendleton, CA 92055-5221 | 2005-08-19 |
| 1609201508 | Craig Hofferber | Dentist | 13128 14th St, Camp Pendleton, CA 92055-5221 | 2013-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730755 | Zaccary Griffin | Military Health Care Provider | Building 4101 Stuart Mesa Rd, Camp Pendleton, CA 92055 | 2020-11-02 |
| 1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
| 1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1548869571 | Joshua Watersjackson | Specialist/Technologist | 430406 Las Pulgas, Camp Pendleton, CA 92055 | 2020-10-21 |
| 1235737164 | Tynesha Felice Calimquim | Dental Hygienist | Naval Hospital Camp Pendleton, Dental Department, 200 Mercy Circle, Oceanside, CA 92055 | 2020-10-13 |
| 1801494182 | Luis Alberto Necoechea | Military Health Care Provider | 1st Recon Bn Bas, Oceanside, CA 92055 | 2020-10-09 |
| 1689271603 | Lorena Santodomingo | Dental Hygienist | Bldg 210735 C Street, Camp Pendleton, CA 92055 | 2020-10-02 |
| 1720695984 | Douglas Thomas Duncan | Dental Assistant | 92055- 14th Strret, Oceanside, CA 92055 | 2020-09-30 |
| 1528675980 | Dora Louise Young | Dental Assistant | 92055 14th Street, Camp Pendleton, CA 92055 | 2020-09-29 |
| 1306453956 | Lynne Marie Reardon | Dental Hygienist | Bldg 310515, Camp Pendleton, CA 92055 | 2020-09-28 |
| Find all providers in zip 92055 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245830736 | Khalid Bey | Student in an Organized Health Care Education/Training Program | 1st Dnbn Attn: Credentials 555221, Camp Pendleton, CA 92055-5221 | 2020-10-26 |
| 1508477530 | Brandon Michael Taylor | Student in an Organized Health Care Education/Training Program | 13 Adc Bldg 14th Street, Camp Pendleton, CA 92055 | 2020-08-13 |
| 1396265203 | Dennis William Chang | Student in an Organized Health Care Education/Training Program | 1st Den Bn/naval Dental Center, Box 555221, Camp Pendleton, CA 92055-5221 | 2017-06-21 |
| 1932550936 | Matthew Lawrence O'reilly | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle, Naval Hospital Camp Pendleton, Camp Pendleton, CA 92055 | 2016-06-30 |
| 1154731206 | Leslie Jared Hyman | Student in an Organized Health Care Education/Training Program | 200 Mercy Circle Attention: Medical Staff Services, Naval Hospital Camp Pendleton, Camp Pendleton, CA 92055-5191 | 2014-04-29 |
| 1124450028 | Danielle Paige Berkowitz | Student in an Organized Health Care Education/Training Program | Building H100 Santa Margarita Rd, Camp Pendleton, CA 92055 | 2013-08-01 |
| 1245662147 | Joshua Heath Jones | Student in an Organized Health Care Education/Training Program | Building H-100 Santa Margarita Rd., Camp Pendleton, CA 92055 | 2013-08-01 |
| 1306278338 | David Mardell Harris | Student in an Organized Health Care Education/Training Program | Santa Margarita Road Building H100, Camp Pendleton, CA 92055 | 2013-08-01 |
| 1023366754 | Jason Christenson | Student in an Organized Health Care Education/Training Program | Nhcp, Box 555191, Camp Pendleton, CA 92055-5191 | 2012-08-28 |
| 1144593955 | Michelle Marie Cormier | Student in an Organized Health Care Education/Training Program | 5/11 Bas, 43505 A Street, 43 Area, Camp Pendleton, CA 92055-5534 | 2012-02-10 |
| Find all providers in CAMP PENDLETON | ||||
| City | CAMP PENDLETON |
| Zip Code | 92055 |
Please comment or provide details below to improve the information on DR. BLAKE WILLIAM SCOTT.
| 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.