Provider Demographics
NPI:1528147527
Name:BLACKWELL, DAN LOWELL (DDS)
Entity type:Individual
Prefix:MR
First Name:DAN
Middle Name:LOWELL
Last Name:BLACKWELL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NW CHIPMAN ROAD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64063-1929
Mailing Address - Country:US
Mailing Address - Phone:816-524-6525
Mailing Address - Fax:816-524-8403
Practice Address - Street 1:10 NW CHIPMAN ROAD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063-1929
Practice Address - Country:US
Practice Address - Phone:816-524-6525
Practice Address - Fax:816-524-8403
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOORTHO3601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics