Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1023360609 Individual Practitioner Male Practitioner

Dr. Shane Christopher Blake , DMD

Dentist • Coudersport, PA

Professional Overview & Biography Verified Profile Summary

Dr. Shane Blake, DMD is a registered healthcare professional specializing in Dentist in Coudersport, PA. Practice services are available at 507 DWIGHT ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

507 Dwight St

Coudersport, PA 169151792

Telephone 8142747262
Fax 8008884760
Associated Practice Facility / Clinic
🏢 Blake Dentistry, Pc Facility NPI 1962567644

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Coudersport, PA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
6 Specialists

Practicing in Coudersport, PA (3554 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License PA DS035521

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: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1871759803

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 08, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location October 08, 2012

Registered at 507 DWIGHT ST, COUDERSPORT, PA 169151792 (Tel: 8142747262)

📍
Updated Business Mailing Address October 08, 2012

Registered at 507 DWIGHT ST, COUDERSPORT, PA 169151792 (Tel: 8142747262)

👤
Provider Name / Credentials Updated October 08, 2012

Recorded as SHANE BLAKE, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 08, 2012

Dentist (License #DS035521 in PA)

🟢
Initial NPI Registration & Enumeration October 08, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1023360609
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 08, 2012
Last Update: October 08, 2012
Sole Proprietor: Yes

Mailing Address

507 Dwight St

Coudersport, PA 169151792

Phone: 8142747262

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.