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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. ALONZO CARLOS BLACKMON D.D.S, M.S.
NPI 1821422908
Dentist - Prosthodontics in Ponte Vedra, FL

Active since August 26, 2013PECOS Enrolled
153 FORT WADE RD STE 100, PONTE VEDRA, FL 32081(904) 395-5501 Get Directions Write a Review

NPPES record last updated: August 17, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 17, 2026, Sep 23, 2020 (2 updates tracked since 2020).

About Dr. Alonzo Carlos Blackmon D.d.s, M.s. NPPES

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

DR. ALONZO CARLOS BLACKMON D.D.S, M.S. (NPI 1821422908) is an individual prosthodontics provider in Ponte Vedra, Florida, licensed in Florida (DN23627) and active in the NPI registry since August 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821422908
Entity TypeIndividualMale
Primary Taxonomy1223P0700X
Provider Legal NameDR. ALONZO CARLOS BLACKMONCredential: D.D.S, M.S.
Location Address153 FORT WADE RD STE 100Ponte Vedra, FL 32081-5205
Mailing Address153 Fort Wade Rd Ste 100Ponte Vedra, FL 32081-5205 · (904) 395-5501
Phone(904) 395-5501
Sole ProprietorNo
Enumeration DateAugust 26, 2013
Last NPPES UpdateAugust 17, 20262 updates tracked since enumeration
NPPES CertifiedAugust 17, 2026
✔ NPI 1821422908 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · ProsthodonticsDental Providers
Taxonomy Code1223P0700X
License✔ Licensed in FL · DN23627
Definition
That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
Also ListedDentistTaxonomy 122300000X · License 0401414082 (VA)
153 FORT WADE RD STE 100, Ponte Vedra, FL 32081
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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. Alonzo Carlos Blackmon D.d.s, M.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 32081 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

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 Alonzo Blackmon's NPI number?

The NPI number for Alonzo Blackmon is 1821422908. It was assigned to this individual provider in the NPPES registry on August 26, 2013.

Where is Alonzo Blackmon located?

Alonzo Blackmon practices at 153 Fort Wade Rd Ste 100, Ponte Vedra, FL 32081. The listed phone number is (904) 395-5501.

What is Alonzo Blackmon's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.

Is Alonzo Blackmon enrolled in Medicare?

Yes. Alonzo Blackmon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alonzo Blackmon was last updated on August 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days 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.