MRS. MARILYN BLACKMUN PDHAP NPI 1790909349

NPI Information

  • NPI: 1790909349
  • Provider Name: MRS. MARILYN BLACKMUN, PDHAP
  • Classification: Dental Hygienist - 124Q00000X
  • Entity Type: Individual
  • Address: 2209 SAN GORGONIO RD
    LA CANADA, CA
    ZIP 91011
  • Phone: (818) 957-1589

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NPI Details

MRS. Marilyn Blackmun, PDHAP is a dental hygienist in La Canada, CA. The provider is an individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. MRS. Marilyn Blackmun, PDHAP NPI is 1790909349. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2209 SAN GORGONIO RD
LA CANADA, CA
ZIP 91011-352
Phone: (818) 957-1589
Fax: (818) 957-1589

The enumeration date for this NPI number is 4/13/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1124Q00000XDental HygienistHAP11CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
128993701MEDICAIDCALIFORNIA
2133068OTHERCALIFORNIADELTA DENTAL INS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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