Stewart H Bloom, GENERAL DENTIST

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2468 Issued in WV

Practice address

1021 Quarrier Street
Medical Arts Building Suite 517
Charleston, WV 25301

Phone

(304) 345-7272

Fax

(304) 345-7287

NPI assigned

Mar 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386760874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 QUARRIER STREET",
            "address_2": "MEDICAL ARTS BUILDING SUITE 517",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25301",
            "telephone_number": "304-345-7272",
            "fax_number": "304-345-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 QUARRIER STREET",
            "address_2": "MEDICAL ARTS BUILDING SUITE 517",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25301",
            "telephone_number": "304-345-7272",
            "fax_number": "304-345-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "STEWART",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "GENERAL DENTIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "2468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136305000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karie Block
• Zici S Bloodstone
• William Zachary Bloodworth
• Bob H Bloom, GENERAL DENTIST
• Juliet Bevan Bloom, MSW, LGSW
• Valarie Bloom, FNP-BC
• Blossom Therapy Services LLC
• Paula Blount, PA
• Tonia Blount, PRSS
• Blue Lot MD PLLC

• General Practice Dentistry in Charleston, WV
• Providers in Charleston, WV by specialty
• General Practice Dentistry in West Virginia

• 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.

Verify at the official NPI Registry.