Michelle Blaisdell, DDS
Individual provider Active NPI Dentist · Warrensburg, NY
NPI 1174200554 · NPPES record last updated Aug 10, 2026
Key facts
- NPI
- 1174200554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 065657 (NY)
- Practice address
- 3761 Main St
Warrensburg, NY 12885-1837 - Phone
- (518) 623-3918
- Fax
- (518) 623-4330
- NPI assigned
- Jun 28, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 065657 | NY | Yes |
Addresses
Primary practice location
3761 Main St
Warrensburg, NY 12885-1837
Mailing address
9 Carey Rd
Queensbury, NY 12804-7880
Phone (518) 761-0300
Other providers in Warrensburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.