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DR. BRUCE A. BLACKBURN D.D.S.
NPI 1689775546
Dentist - General Practice in Kokomo, IN

Active since September 25, 2006PECOS Enrolled
200 S DIXON RD, KOKOMO, IN 46901(765) 456-3015(765) 456-1825 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Bruce A. Blackburn D.d.s. NPPES

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

DR. BRUCE A. BLACKBURN D.D.S. (NPI 1689775546) is an individual general practice provider in Kokomo, Indiana, licensed in Indiana (12007761A) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689775546
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. BRUCE A. BLACKBURNCredential: D.D.S.
Location Address200 S DIXON RDKokomo, IN 46901-5073
Mailing Address200 S Dixon RdKokomo, IN 46901-5073 · (765) 456-3015 · Fax (765) 456-1825
Phone(765) 456-3015
Fax(765) 456-1825
Sole ProprietorYes
Enumeration DateSeptember 25, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1689775546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in IN · 12007761A
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.
200 S DIXON RD, Kokomo, IN 46901
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Bruce A. Blackburn D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

DR. PAUL ANDREW MILLER DDS
Dentist
200 S DIXON RD
KOKOMO, IN 46901
Howard County (765) 456-3015
DR. SUSAN LYNN BLACKBURN D.D.S.
Dentist (General Practice)
200 S DIXON RD
KOKOMO, IN 46901
Howard County (765) 456-3015

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 Bruce Blackburn's NPI number?

The NPI number for Bruce Blackburn is 1689775546. It was assigned to this individual provider in the NPPES registry on September 25, 2006.

Where is Bruce Blackburn located?

Bruce Blackburn practices at 200 S Dixon Rd, Kokomo, IN 46901. The listed phone number is (765) 456-3015.

What is Bruce Blackburn's specialty?

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

Is Bruce Blackburn enrolled in Medicare?

Yes. Bruce Blackburn is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bruce Blackburn was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.