Individual provider Active NPI

Amy Blazejewski, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Henderson, NV
National Provider Identifier
1134005648
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
7871 Issued in NV
Practice address
4 Sunset Way
Henderson, NV 89014-2015
Phone
(215) 680-3255
NPI assigned
Aug 12, 2025
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 7871 NV Primary

Addresses

Primary practice location

4 Sunset Way
Henderson, NV 89014-2015

Mailing address

2030 Olympic Ave Apt 2108
Henderson, NV 89014-2282
Phone (215) 680-3255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7871NVMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1754956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1134005648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 OLYMPIC AVE APT 2108",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142282",
            "telephone_number": "215-680-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SUNSET WAY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890142015",
            "telephone_number": "215-680-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZEJEWSKI",
        "first_name": "AMY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-12",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "7871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.