Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Blake James Willoughby II, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1043772742

Dr. Blake James Willoughby II, DDS is a Student in an Organized Health Care Education/Training Program in Palm Beach Gardens, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2019
Specialties on file
2
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

3400 Burns Rd Ste 100
Palm Beach Gardens, FL 33410-4352
Phone: (561) 627-2122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DN24534 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1043772742
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedApril 2, 2019
Last updated in NPPESMarch 7, 2023
Certification dateMarch 7, 2023

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