Michael Bliss, D.M.D.
Individual provider Active NPI Dentist · Silverton, OR
NPI 1083940977 · NPPES record last updated Aug 28, 2013
Key facts
- NPI
- 1083940977
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D9331 (OR)
- Practice address
- 306 E Main St
Silverton, OR 97381-1715 - Phone
- (503) 873-6118
- Fax
- (503) 873-8220
- NPI assigned
- Oct 27, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160118000643 | OR | Order and Referring Only - Dentist |
3678876133 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D9331 | OR | Yes |
Addresses
Primary practice location
306 E Main St
Silverton, OR 97381-1715
Mailing address
306 E Main St
Silverton, OR 97381-1715
Phone (503) 873-6118
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500613587 | Medicaid | OR |
Other providers in Silverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.