RICHARD W BLAKE DDS PA
NPI 1558701177
Dentist - Pediatric Dentistry in Jacksonville, FL

Q: What is Richard W Blake Dds PA's NPI number?

The NPI number for Richard W Blake Dds PA is 1558701177. It was assigned to this organization in the NPPES registry on June 27, 2013.

Q: What is Richard W Blake Dds PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Active since June 27, 2013

943 CESERY BLVD STE D, JACKSONVILLE, FL 32211(904) 743-2000(904) 744-0598 Get Directions Write a Review

NPPES record last updated: June 27, 2013. Verified against the NPPES registry weekly; last sync: October 04, 2026.

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About Richard W Blake Dds Pa NPPES

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

RICHARD W BLAKE DDS PA (NPI 1558701177) is a healthcare organization registered as a pediatric dentistry in Jacksonville, Florida and active in the NPI registry since June 2013. The organization lists Richard Wayne Blake, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1558701177

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NameRICHARD W BLAKE DDS PA

Location Address943 CESERY BLVD STE DJacksonville, FL 32211-5655

Mailing Address943 Cesery Blvd Ste DJacksonville, FL 32211-5655 · (904) 743-2000 · Fax (904) 744-0598

Phone(904) 743-2000

Fax(904) 744-0598

Organization SubpartNo

Authorized OfficialRichard Wayne BlakeOwner/president · 19047432000

Enumeration DateJune 27, 2013

✔ NPI 1558701177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers

Taxonomy Code1223P0221X

License✔ Licensed in FL · 0005634

Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

943 CESERY BLVD STE D, Jacksonville, FL 32211

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Other Identifiers 1

Medicaid074223600FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Richard W Blake Dds PA's NPI number?

The NPI number for Richard W Blake Dds PA is 1558701177. It was assigned to this organization in the NPPES registry on June 27, 2013.

Where is Richard W Blake Dds PA located?

Richard W Blake Dds PA is located at 943 Cesery Blvd Ste D, Jacksonville, FL 32211. The listed phone number is (904) 743-2000.

What is Richard W Blake Dds PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Richard W Blake Dds PA was last updated on June 27, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.