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

Dr. Blake Edwin Moore, DDS

Individual provider Pediatric Dentistry · NPI 1801883756

Dr. Blake Edwin Moore, DDS is a Pediatric Dentistry in Folsom, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2005
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

2190 E Bidwell St
Folsom, CA 95630-6453
Phone: (916) 984-0304
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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 64252 (CA)

Record details

NPI number1801883756
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedOctober 5, 2005
Last updated in NPPESDecember 25, 2019
Certification dateDecember 25, 2019
Mailing address2190 E Bidwell St, Folsom, CA 95630-6453

Other providers in Folsom