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NPI 1356072797

NPI 1356072797 : HAYLEY BLANKENSHIP DDS : BELLEVUE, NE

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General NPI Number Information
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    NPI Number           |    1356072797
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    Entity Type          |    Individual 
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    Provider Name        |    HAYLEY BLANKENSHIP DDS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/17/2022
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    Last Update Date     |    06/17/2022
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Provider Practice Location Address
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    Address Line         |    3672 LEXINGTON AVE # 1 
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    City                 |    BELLEVUE
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    State                |    NE
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    Zip                  |    68123-1321
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    Country              |    US
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    Telephone            |    402-292-1200
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3672 LEXINGTON AVE # 1 
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    City                 |    BELLEVUE
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    State                |    NE
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    Zip                  |    68123-1321
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    7827
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    License Number State |    NE
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