DR. BLAKE BORELLO D.D.S., M.S.
NPI 1902114515
Dentist - Orthodontics and Dentofacial Orthopedics in Lake Saint Louis, MO

Active since September 16, 2010
6288 RONALD REAGAN DR., LAKE SAINT LOUIS, MO 63367(636) 625-4224(314) 845-1864 Get Directions Write a Review

NPPES record last updated: February 2, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Blake Borello D.d.s., M.s. NPPES

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

DR. BLAKE BORELLO D.D.S., M.S. (NPI 1902114515) is an individual orthodontics and dentofacial orthopedics provider in Lake Saint Louis, Missouri, licensed in Missouri (2008019644) and active in the NPI registry since September 2010.

NPPES Registry Identity

NPI1902114515
Entity TypeIndividualMale
Primary Taxonomy1223X0400X
Provider Legal NameDR. BLAKE BORELLOCredential: D.D.S., M.S.
Location Address6288 RONALD REAGAN DR.Lake Saint Louis, MO 63367
Mailing Address1203 Saint Charles St, Apt. 5aSaint Louis, MO 63103-1963 · (636) 625-4224 · Fax (314) 845-1864
Fax(314) 845-1864
Sole ProprietorNo
Enumeration DateSeptember 16, 2010
Last NPPES UpdateFebruary 2, 2011
NPI 1902114515 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Orthodontics and Dentofacial OrthopedicsDental Providers
Taxonomy Code1223X0400X
License Licensed in MO · 2008019644
Definition
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures.
6288 RONALD REAGAN DR., Lake Saint Louis, MO 63367

Other Providers at the Same Location NPPES

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

Clinic/Center (Dental)
6288 RONALD REAGAN DR.
LAKE SAINT LOUIS, MO 63367

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 Blake Borello's NPI number?

The NPI number for Blake Borello is 1902114515. It was assigned to this individual provider in the NPPES registry on September 16, 2010.

Where is Blake Borello located?

Blake Borello practices at 6288 Ronald Reagan Dr., Lake Saint Louis, MO 63367. The listed phone number is (636) 625-4224.

What is Blake Borello's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Orthodontics and Dentofacial Orthopedics, with taxonomy code 1223X0400X.

When was this NPI record last updated?

The NPPES record for Blake Borello was last updated on February 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.