Doctor Micah J'King Blaze, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30.026412 Issued in OH

Practice address

5 E Liberty St
Cincinnati, OH 45202-8202

Phone

(513) 721-6060

NPI assigned

Apr 16, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Michael J. Brooks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1124681069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 6TH ST",
            "city": "CAMPBELL",
            "state": "OH",
            "postal_code": "444051140",
            "telephone_number": "513-805-3894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 E LIBERTY ST",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452028202",
            "telephone_number": "513-721-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZE",
        "first_name": "DOCTOR MICAH J'KING",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-16",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026412",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026412",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL J.",
            "last_name": "BROOKS",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Molly Elizabeth Blatt, CNP
• Stephen Patrick Blatt, MD
• Carissa Blatz, LSW
• James Blau
• Matthew Blau
• Anna Blecha, DO
• Saul Blecher, MD
• Alice Michelle Bledsoe, CDCA
• Jessica Bledsoe
• Jacob Jan Hendrik Bleesing, M.D.

• Dentist in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.