Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1669517330 Individual Practitioner Male Practitioner

Dr. Thomas R Blake , DDS

Dentist - General Practice • Fort Wayne, IN

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Blake, DDS is a registered healthcare professional specializing in Dentist - General Practice in Fort Wayne, IN. Practice services are available at 2409 FAIROAK DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2409 Fairoak Dr

Fort Wayne, IN 468092301

Telephone 2607475745
Associated Practice Facility / Clinic
🏢 Jsbc Services Llc Facility NPI 1912886920

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Fort Wayne, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 1.5 Yrs
State Avg: 14.3 Yrs
Regional Practice Density
148 Specialists

Practicing in Fort Wayne, IN (2204 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 - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IN 7973

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID United Concordia
777279 (IN)
Commercial Insurance / Payer ID Php
1091 (IN)

Practice Associates & Co-Workers

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

2 Associated Practitioners
NPI 1093380404

Doctor of Dental Surgery

Dr. Hayden Turnbow , DDS

Dentist - General Practice

NPI 1861324287

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2007

Registered at 2409 FAIROAK DR, FORT WAYNE, IN 468092301 (Tel: 2607475745)

📍
Updated Business Mailing Address July 09, 2007

Registered at 2409 FAIROAK DR, FORT WAYNE, IN 468092301 (Tel: 2607475745)

👤
Provider Name / Credentials Updated July 09, 2007

Recorded as THOMAS BLAKE, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Dentist (License #7973 in IN)

🟢
Initial NPI Registration & Enumeration February 21, 2007

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: 1669517330
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 21, 2007
Last Update: July 09, 2007
Sole Proprietor: Yes

Mailing Address

2409 Fairoak Dr

Fort Wayne, IN 468092301

Phone: 2607475745

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.