Glenda Lopez-Blaza MD, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GLENDA LOPEZ-BLAZA MD, LLC

Practice address

8710 N Dixie Dr
Dayton, OH 45414-2406

Phone

(937) 415-0501

Fax

(937) 415-0520

NPI assigned

May 18, 2006

Last updated

Jun 20, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Glenda Joy Lopez-Blaza, MDNPI 1356333967

Title

Owner

Phone

(937) 415-0501

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Glenda Joy Lopez-Blaza, M.D.

  • Internal Medicine Physician
  • Dayton, OH
  • NPI 1356333967
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308528000000",
    "number": "1033162169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8710 N DIXIE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454142406",
            "telephone_number": "937-415-0501",
            "fax_number": "937-415-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 N DIXIE DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454142406",
            "telephone_number": "937-415-0501",
            "fax_number": "937-415-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDA LOPEZ-BLAZA MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-06-20",
        "status": "A",
        "authorized_official_last_name": "LOPEZ-BLAZA",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-415-0501",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0983002",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2988272",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert George Glaser, PH.D.
• Virginia Louise Glass
• Jordan Glassman, DO
• Kathleen D Glaus, PHD, PSYD
• Paul Douglas Gleason II, M.D.
• Brian Michael Glenn, CRNA
• Jessica T Glenn, MOTR/L
• William Glenn, MD
• Global Initiative for Theraputic Services (Gifts), LLC
• Global Med Services LLC (Harmony Adult Day Services)

• Internal Medicine Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.