Richard W Blake Dds Pa
Pediatric Dental Clinic
943 Cesery Blvd Ste D, Jacksonville
Florida, 32211-5655
904-743-2000 904-744-0598
Maps & DirectionsRichard W Blake Dds Pa is a Pediatric Dental Clinic in Jacksonville, Florida. It is located at 943 Cesery Blvd Ste D, Jacksonville, FL and its contact number is 904-743-2000. The authorized person for Richard W Blake Dds Pa is Dr. Richard Wayne Blake
who is Owner/president of the clinic and their contact number is 190-474-32000. The primary license number for Richard W Blake Dds Pa is 0005634 (Pediatric Dentistry) in Florida.
Richard W Blake Dds Pa Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Richard W Blake Dds Pa Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Richard W Blake Dds Pa |
| Specialization: | Pediatric Dentistry |
| Clinic Address: | 943 Cesery Blvd Ste D, Jacksonville,
Florida, 32211-5655 |
| Phone: | 904-743-2000 |
| Fax: | 904-744-0598 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Richard Wayne Blake |
| Position: | Owner/president |
| Contact Number: | 190-474-32000 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Richard W Blake Dds Pa clinic are as mentioned below.
| NPI Number: | 1558701177 |
| NPI Enumeration Date: | 27 Jun, 2013 |
| NPI Last Update On: | 27 Jun, 2013 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Richard W Blake Dds Pa are as mentioned below.
| Specialization | License Number | State | Status | |
| Pediatric Dentistry | 0005634 | Florida | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 074223600 | Medicaid | Florida | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Richard W Blake Dds Pa
943 Cesery Blvd Ste D,
Jacksonville, Florida |
| Zip: | 32211-5655 |
| Phone Number: | 904-743-2000 |
| Fax Number: | 904-744-0598 |
Patients can reach Richard W Blake Dds Pa at
943 Cesery Blvd Ste D, Jacksonville, Florida or can
call to book an appointment on 904-743-2000.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.