Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1548790207 Individual Practitioner Female Practitioner

Dr. Marissa Ann Blackwell , DDS

Dentist - General Practice • San Angelo, TX

Professional Overview & Biography Verified Profile Summary

Dr. Marissa Blackwell, DDS is a registered healthcare professional specializing in Dentist - General Practice in San Angelo, TX. Practice services are available at 2902 W BEAUREGARD AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2902 W Beauregard Ave

San Angelo, TX 769013644

Telephone 3259490114

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in San Angelo, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
38 Specialists

Practicing in San Angelo, TX (10570 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

CMS Verified: 2022-04-04
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 32921

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.

Practice Associates & Co-Workers

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

1 Associated Practitioners
Dr. Shelly Stromboe , DDS

Dentist - General Practice

NPI 1962628511

Doctor of Dental Surgery

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Business Mailing Address April 04, 2022

Registered at 2902 W BEAUREGARD AVE, SAN ANGELO, TX 769013644

👤
Provider Name / Credentials Updated April 04, 2022

Recorded as MARISSA BLACKWELL, DDS

NPI Profile Active June 15, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 15, 2017

Registered at 2902 W BEAUREGARD AVE, SAN ANGELO, TX 769013644 (Tel: 3259490114)

📍
Updated Business Mailing Address June 15, 2017

Registered at 1732 UTAH AVE, SAN ANGELO, TX 769047149 (Tel: 3252323765)

👤
Provider Name / Credentials Updated June 15, 2017

Recorded as MARISSA STEWART, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 15, 2017

Dentist (License #32921 in TX)

🟢
Initial NPI Registration & Enumeration June 15, 2017

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: 1548790207
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 15, 2017
Last Update: April 04, 2022
Sole Proprietor: No

Mailing Address

2902 W Beauregard Ave

San Angelo, TX 769013644

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.