Matthew Bloomberg, D.M.D. , M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2901021647 Issued in MI

Practice address

4111 Okemos Rd Ste 201
Okemos, MI 48864-3235

Phone

(517) 347-0946

NPI assigned

Jan 4, 2016

Last updated

Mar 24, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• Kristine S West DDS Ms and Donald R Burkhardt DDS Ms PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Okemos, MI
  • NPI 1982826749
  NPD (past)

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1093171233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 OKEMOS RD STE 201",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 OKEMOS RD STE 201",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643235",
            "telephone_number": "517-347-0946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1040 Charlevoix Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Grand Ledge",
            "state": "MI",
            "postal_code": "488372417",
            "country_code": "US",
            "telephone_number": "517-347-0946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOMBERG",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.M.D. , M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-04",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021647",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": "2901021647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Blake
• Megan Bliesener
• Douglas L Block, LSW, ACSW
• Bloom Within Counseling LLC
• Madison Bloom, DNP, FNP-BC
• Blue Arrow Therapy
• Blue Horizons Counseling and Supervision
• Blue Lake Homecare Mi, LLC
• Julia Bockenstette
• Alex Bodell

• Orthodontics and Dentofacial Orthopedics Dentistry in Okemos, MI
• Providers in Okemos, MI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.