Individual provider · Type 1 NPI
Alonzo Carlos Blackmon, D.D.S, M.S.
Prosthodontics · Ponte Vedra, FL
NPI number
1821422908
Active
Practice location
153 Fort Wade Rd Ste 100
Ponte Vedra, FL 32081-5205
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | 0401414082 (VA) |
| Prosthodontics Primary | 1223P0700X | DN23627 (FL) |
Prosthodontics: That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
About NPI 1821422908
Alonzo Carlos Blackmon, D.D.S, M.S.'s National Provider Identifier is 1821422908, issued on Aug 26, 2013. The primary taxonomy on file is Prosthodontics (1223P0700X), and the practice location is in Ponte Vedra, FL. The record was last updated on Aug 17, 2026.