Individual provider Active NPI

Aaron M Bliley, D.M.D.

  • General Practice Dentistry
  • Beaufort, SC
National Provider Identifier
1366638462
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3973 Issued in SC
Practice address
17A Marshellen Dr
Beaufort, SC 29902-6900
Phone
(843) 524-9020
Fax
(843) 524-9525
NPI assigned
Sep 21, 2007
Last updated
Jan 8, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3973 SC Primary

Addresses

Primary practice location

17A Marshellen Dr
Beaufort, SC 29902-6900

Mailing address

17A Marshellen Dr
Beaufort, SC 29902-6900
Phone (843) 524-9020

Other identifiers 1

IdentifierTypeStateIssuer
ZX3973MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160620001297 SC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5698066835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aaron M. Bliley DMD LLC General Practice Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1366638462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17A MARSHELLEN DR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026900",
            "telephone_number": "843-524-9020",
            "fax_number": "843-524-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17A MARSHELLEN DR",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026900",
            "telephone_number": "843-524-9020",
            "fax_number": "843-524-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLILEY",
        "first_name": "AARON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3973",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

Verify at the official NPI Registry.