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DR. MARISSA ANN BLACKWELL DDS
NPI 1548790207
Dentist - General Practice in San Angelo, TX

Active since June 15, 2017
2902 W BEAUREGARD AVE, SAN ANGELO, TX 76901(325) 949-0114 Get Directions Write a Review

NPPES record last updated: April 4, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 4, 2022, Jun 15, 2017 (2 updates tracked since 2017).

About Dr. Marissa Ann Blackwell Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARISSA ANN BLACKWELL DDS (NPI 1548790207) is an individual general practice provider in San Angelo, Texas, licensed in Texas (32921) and active in the NPI registry since June 2017.

NPPES Registry Identity

NPI1548790207
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. MARISSA ANN BLACKWELLCredential: DDS
Location Address2902 W BEAUREGARD AVESan Angelo, TX 76901-3644
Mailing Address2902 W Beauregard AveSan Angelo, TX 76901-3644
Phone(325) 949-0114
Sole ProprietorNo
Enumeration DateJune 15, 2017
Last NPPES UpdateApril 4, 20222 updates tracked since enumeration
NPPES CertifiedApril 4, 2022
✔ NPI 1548790207 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in TX · 32921
Definition
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.
2902 W BEAUREGARD AVE, San Angelo, TX 76901
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SHELLY E. STROMBOE D.D.S.
Dentist (General Practice)
2902 W BEAUREGARD AVE
SAN ANGELO, TX 76901
Tom Green County (325) 944-0114

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marissa Blackwell's NPI number?

The NPI number for Marissa Blackwell is 1548790207. It was assigned to this individual provider in the NPPES registry on June 15, 2017.

Where is Marissa Blackwell located?

Marissa Blackwell practices at 2902 W Beauregard Ave, San Angelo, TX 76901. The listed phone number is (325) 949-0114.

What is Marissa Blackwell's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Marissa Blackwell was last updated on April 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.