Max Harley Blumenthal, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS043695 Issued in PA

Practice address

6 Oriole Ave
Media, PA 19063-4515

Phone

(610) 679-6109

NPI assigned

Jun 22, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
• devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
• devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1003547829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SIBLEY AVE APT 208",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032347",
            "telephone_number": "610-761-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ORIOLE AVE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190634515",
            "telephone_number": "610-679-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMENTHAL",
        "first_name": "MAX",
        "middle_name": "HARLEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS043695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Water Home Care (Right at Home Main Line)
• Samantha Bluj, RD, LDN
• Edan Blumenthal, DMD
• Jordan Scott Blumenthal, DMD
• Mary Ann Blumenthal, PSYD
• Casey B Boberick, DPT
• Levente Zsolt Bodak-Gyovai, D.M.D
• Leslie J Bohn, LMT
• Susan T Boland, P.T.
• Andreas Bollmann, MD

• General Practice Dentistry in Media, PA
• Providers in Media, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.