Individual provider Active NPI

Michael Bliss, D.M.D.

  • Dentist
  • Silverton, OR
National Provider Identifier
1083940977
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D9331 Issued in OR
Practice address
306 E Main St
Silverton, OR 97381-1715
Phone
(503) 873-6118
Fax
(503) 873-8220
NPI assigned
Oct 27, 2009
Last updated
Aug 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D9331 OR Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20160118000643 OR Order and Referring Only - DentistPractitioner - Dentist 3678876133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1083940977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E MAIN ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973811715",
            "telephone_number": "503-873-6118",
            "fax_number": "503-873-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 E MAIN ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973811715",
            "telephone_number": "503-873-6118",
            "fax_number": "503-873-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLISS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-27",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverton, OR

Sources for this page

Verify at the official NPI Registry.