NPIMap

Organization Active NPI

Bloy Family Dentistry LLC

  • Dentist
  • Jackson, WI
National Provider Identifier
1396342291
Registry record updated Oct 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BLOY FAMILY DENTISTRY LLC
Practice address
W213N16755 Glen Brooke Dr
Jackson, WI 53037-9489
Phone
(262) 677-4990
NPI assigned
Oct 4, 2020
Last updated
Oct 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2020

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

Authorized official

Name
Mitch Weiland
Title
Senior Accountant
Phone
(608) 343-0818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

W213N16755 Glen Brooke Dr
Jackson, WI 53037-9489

Mailing address

W213N16755 Glen Brooke Dr
Jackson, WI 53037-9489
Phone (262) 677-4990

National Provider Directory

National Provider Directory

Locations

W213N16755 Glen Brooke Dr
Jackson, WI 53037
Phone (262) 677-4990

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1601769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601769600000",
    "number": "1396342291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W213N16755 GLEN BROOKE DR",
            "city": "JACKSON",
            "state": "WI",
            "postal_code": "530379489",
            "telephone_number": "262-677-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W213N16755 GLEN BROOKE DR",
            "city": "JACKSON",
            "state": "WI",
            "postal_code": "530379489",
            "telephone_number": "262-677-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOY FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-04",
        "last_updated": "2020-10-04",
        "certification_date": "2020-10-04",
        "status": "A",
        "authorized_official_last_name": "WEILAND",
        "authorized_official_first_name": "MITCH",
        "authorized_official_title_or_position": "SENIOR ACCOUNTANT",
        "authorized_official_telephone_number": "608-343-0818"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2020; 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.