OrganizationActive
Blackstockdentalcorp
NPI 1417168881 · General Practice Dentistry · Lakeside, CA
Blackstockdentalcorp is a General Practice Dentistry organization in Lakeside, CA (NPI 1417168881).
Provider details
- NPI number
- 1417168881
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Burch Blackstock, Dentist(619) 443-0444
- License
- 42123 (CA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12110 Woodside Ave
Lakeside, CA 92040-3012
Phone: (619) 443-0444
Fax: (619) 443-0050
Street-level locationGet directions
Mailing address
12110 Woodside Ave.
Lakeside, CA 92040-3012
Registry dates
- Enumerated
- 2007-05-25
- Last updated
- 2016-02-10
Frequently asked questions
- What is Blackstockdentalcorp's NPI number?
- Blackstockdentalcorp's National Provider Identifier (NPI) is 1417168881, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Blackstockdentalcorp?
- Blackstockdentalcorp is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Blackstockdentalcorp located?
- Blackstockdentalcorp's practice location on file with NPPES is 12110 Woodside Ave, Lakeside, CA 92040-3012.
- What is Blackstockdentalcorp's phone number?
- The practice phone number listed in the NPPES registry for Blackstockdentalcorp is (619) 443-0444.
- Who is the authorized official for Blackstockdentalcorp?
- The authorized official listed on Blackstockdentalcorp's NPPES record is Burch Blackstock, Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Blackstockdentalcorp's NPI active?
- Yes — Blackstockdentalcorp's NPI (1417168881) is active in the NPPES registry as of the last update on 2016-02-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.