Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Richard W Blake DDS PA

Organization Pediatric Dentistry · NPI 1558701177

Richard W Blake DDS PA is a Pediatric Dentistry in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2013.

Licensed in
FL
In the registry since
2013
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

943 Cesery Blvd Ste D
Jacksonville, FL 32211-5655
Phone: (904) 743-2000
Fax: (904) 744-0598
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 0005634 (FL)

Record details

NPI number1558701177
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Blake — Owner/President · (904) 743-2000
NPI enumeratedJune 27, 2013
Last updated in NPPESJune 27, 2013
Mailing address943 Cesery Blvd Ste D, Jacksonville, FL 32211-5655

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