NPI 1104751007 · live from the CMS NPI Registry
Blackhurst Periodontics, P.A.
Dentist, Periodontics in Wilmington, DE. National Provider Identifier 1104751007, active.
NPI record
| NPI | 1104751007 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Periodontics 1223P0300X |
| Practice location | 2710 Centerville Rd Ste 205, Wilmington, DE 19808 |
| Practice phone | 302-507-3784 |
| Enumerated | June 15, 2026 |
| Last updated | September 7, 2026 |
| Authorized official | Victoria Blackhurst, Owner, Periodontist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Periodontics primary | 1223P0300X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.