Julie A Bloy, DDS

Individual provider Active NPI General Practice Dentistry · Jackson, WI

NPI 1043364144 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1043364144
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
4260-015 (WI)
Practice address
W213N16755 Glen Brooke Dr
Jackson, WI 53037-9489
Phone
(262) 677-4990
Fax
(262) 677-9280
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4260-015WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bloy Family Dentistry LLC Past
since Oct 11, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4260-015 WI Yes

Addresses

Primary practice location

W213N16755 Glen Brooke Dr
Jackson, WI 53037-9489

Mailing address

W213N16755 Glen Brooke Dr
PO Box 37
Jackson, WI 53037-9489
Phone (262) 677-4990

Other providers in Jackson, WI

All providers in Jackson, WI · General Practice Dentistry in Wisconsin

Sources for this page

Verify at the official NPI Registry.