Nyle Bradley Blanck, D.M.D., M.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

12761 Issued in CT

Practice address

23 Church Hill Rd
Newtown, CT 06470-1612

Phone

(203) 426-5900

NPI assigned

May 10, 2017

Last updated

Jun 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Myorthos Connecticut Orthodontics, P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Newtown, CT
  • NPI 1417628397
  NPD
• Joshua E. Baum, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Newtown, CT
  • NPI 1467743518
  NPD (past)

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1386170454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 PARK CIR",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064604832",
            "telephone_number": "203-868-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CHURCH HILL RD",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701612",
            "telephone_number": "203-426-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 Farmington Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061053041",
            "country_code": "US",
            "telephone_number": "860-956-5555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "06030",
            "country_code": "US",
            "telephone_number": "860-679-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "241 Monroe Tpke",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "CT",
            "postal_code": "064682248",
            "country_code": "US",
            "telephone_number": "203-261-0650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANCK",
        "first_name": "NYLE",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-10",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CT",
            "license": "12761",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Marie Bernz, PT, DPT
• Paul Robert Berry, P.T.
• Stephanie Krok Berry, P.T.
• Urmi Abhay Bhatt, PT
• Christine Bihday, APRN
• Nicholas Boccarossa, DMD
• Tod Jeffrey Bogdanoff, PSY.D.
• Susan A. Boritz, M.A.
• Valerie Ngangoua Bouhom, DMD
• Chandel Marie Bouthot, FNP

• Orthodontics and Dentofacial Orthopedics Dentistry in Newtown, CT
• Providers in Newtown, CT by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.