Provider Demographics
NPI:1235921438
Name:HARVEY, BLAKE LOUIS (DMD)
Entity type:Individual
Prefix:
First Name:BLAKE
Middle Name:LOUIS
Last Name:HARVEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 DOLEN PL
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4523
Mailing Address - Country:US
Mailing Address - Phone:309-706-6964
Mailing Address - Fax:
Practice Address - Street 1:801 NEWTON RD
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-8004
Practice Address - Country:US
Practice Address - Phone:319-335-7274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program