Provider Demographics
NPI:1184756694
Name:JAMES C. BLANKENHORN DMD
Entity type:Organization
Organization Name:JAMES C. BLANKENHORN DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CALVIN
Authorized Official - Last Name:BLANKENHORN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-683-6677
Mailing Address - Street 1:162 TREXLER AVE
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-9707
Mailing Address - Country:US
Mailing Address - Phone:610-683-6677
Mailing Address - Fax:610-683-9418
Practice Address - Street 1:162 TREXLER AVE
Practice Address - Street 2:
Practice Address - City:KUTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19530-9707
Practice Address - Country:US
Practice Address - Phone:610-683-6677
Practice Address - Fax:610-683-9418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-021204-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty