Organization
BLACKBURN WC DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD BLACKBURN DMD (OWNER/DENTIST)
(562) 596-7484
Entity
Organization
Contact information
Practice address
3532 HOWARD AVE STE 200, LOS ALAMITOS, CA 90720-3699
(562) 596-7484
(562) 430-3754
Mailing address
3532 HOWARD AVE STE 200, LOS ALAMITOS, CA 90720-3699
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223D0004X
Dental Anesthesiology
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
1223X2210X
Orofacial Pain Dentistry
—
—
Other
Enumeration date
04/15/2025
Last updated
03/04/2026
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