Blake Kunimoto is a Dentist in Springfield, Illinois. Blake Kunimoto practices all healthcare services and medical treatments related to Dentist. The NPI Number for Blake Kunimoto is 1205056207. The last update date is 2007-07-08.
Blake Kunimoto's current location address is 3124 Montvale Dr, Springfield, Illinois. You can contact this provider via phone number 2175468777. The mailing address for Blake Kunimoto is 3124 Montvale Dr, Springfield, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Blake Kunimoto |
|---|---|
| Address | 3124 Montvale Dr, Springfield, Illinois |
| Phone Number | 2175468777 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1205056207 |
|---|---|
| Provider Enumeration Date | 2007-05-01 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3124 Montvale Dr |
|---|---|
| City | Springfield |
| State | Illinois (IL) |
| Post Code | 627046937 |
| Phone Number | 2175468777 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 19025927 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identifier code assigned to Blake Kunimoto by the Centers for Medicare & Medicaid Services?
The Blake Kunimoto has been issued the NPI (National Provider Identifier) 1205056207 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Blake Kunimoto is physically located?
The Blake Kunimoto is physically situated at the following address: 3124 Montvale Dr, Springfield, IL, 627046937.
What is Blake Kunimoto's specialized field of practice, and what is the corresponding taxonomy classification code?
The Blake Kunimoto's area of specialization is Dentist, and the corresponding taxonomy code that categorizes this field of practice is 122300000X.
On what date did the Blake Kunimoto receive its 1205056207 assignment from the Centers for Medicare & Medicaid Services?
The Blake Kunimoto was assigned its 1205056207 by the Centers for Medicare & Medicaid Services on 2007-05-01.
As of what date were the details related to Blake Kunimoto most recently updated or revised?
The information pertaining to Blake Kunimoto, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.