Eric Walter Bludau, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN 15939 Issued in FL

Practice address

385 Harbor Blvd
Ste 210
Destin, FL 32541-2351

Phone

(850) 650-5067

Fax

(850) 650-5347

NPI assigned

Oct 10, 2006

Last updated

Sep 25, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1073601548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 HARBOR BLVD",
            "address_2": "STE 210",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412351",
            "telephone_number": "850-650-5067",
            "fax_number": "850-650-5347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 HARBOR BLVD",
            "address_2": "STE 210",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412351",
            "telephone_number": "850-650-5067",
            "fax_number": "850-650-5347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUDAU",
        "first_name": "ERIC",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN 15939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jo Elizabeth Blazer, PTA
• Wendy Blevins, PCC, NCC, LCDC-III
• Calvin L Blount Jr., M.D.
• Blu by the Sea, LLC
• Blu by the Sea,LLC
• Blue Tide Pediatric Therapy LLC (Blue Tide Therapy)
• Bluewater Dermatology, P.L.L.C.
• Bluewater Medical Billing, LLC
• Bluewater Orthopedics PA
• Dia Bobb, FNP

• Endodontics in Destin, FL
• Providers in Destin, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.