Active NPI
Irving Blau, DDS
- General Practice Dentistry
- Dearborn HTS, MI
National Provider Identifier
1366545527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9971
- Practice address
- 24415 W Warren St
Dearborn HTS, MI 48127-2223 - Phone
- (313) 278-4470
- Fax
- (313) 278-0124
- NPI assigned
- Sep 6, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9971 | MI | Primary |
Addresses
Primary practice location
24415 W Warren St
Dearborn HTS, MI 48127-2223
Mailing address
3835 Spanish Oaks Dr
W Bloomfield, MI 48323-1867
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9971 | MI | MD | General Practice Dentistry |
Organizations & group practices 1
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.
-
- Dentist
- Dearborn HTS, MI
- NPI 1689829913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366545527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3835 SPANISH OAKS DR",
"city": "W BLOOMFIELD",
"state": "MI",
"postal_code": "483231867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24415 W WARREN ST",
"city": "DEARBORN HTS",
"state": "MI",
"postal_code": "481272223",
"telephone_number": "313-278-4470",
"fax_number": "313-278-0124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAU",
"first_name": "IRVING",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "9971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn HTS, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.