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Blake Imam, DMD — NPI 1285040394, Meridian, ID | NPI Central

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NPI 1285040394

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Blake Imam, DMD

NPI 1285040394 · Dentist · Meridian, ID

Provider details

NPI number: 1285040394
Entity type: Individual
Primary specialty: DentistDental Providers
Credential: DMD
Sex: Male
Sole proprietor: No
License: D-4604 (ID)

Specialties & taxonomies

DentistPrimary122300000XLicense D-4604 (ID)
Dental Providers

Practice location

317 W Cherry Ln

Meridian, ID 83642-1608

Phone: (208) 888-2055

Fax: (208) 395-1017

Approximate (ZIP-level) locationGet directions

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Mailing address

317 W Cherry Ln

Meridian, ID 83642-1608

Registry dates

Enumerated: 2014-07-09
Last updated: 2014-07-09

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.