Provider Demographics
NPI:1023850708
Name:BLAIRE, CAILEN MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:CAILEN
Middle Name:MARIE
Last Name:BLAIRE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 LATTAVO DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1844
Mailing Address - Country:US
Mailing Address - Phone:724-456-1287
Mailing Address - Fax:
Practice Address - Street 1:5711 SHIELDS RD STE A
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-9813
Practice Address - Country:US
Practice Address - Phone:330-621-5957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-12
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0446881223G0001X
OH30.028217122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice