Active NPI
William J Blaumer, DMD
- General Practice Dentistry
- Salem, OR
National Provider Identifier
1447258165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5026
- Practice address
- 1355 Edgewater St NW
Salem, OR 97304-4077 - Phone
- (503) 588-6960
- Fax
- (503) 365-0056
- NPI assigned
- Jul 7, 2005
- 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 | 5026 | OR | Primary |
Addresses
Primary practice location
1355 Edgewater St NW
Salem, OR 97304-4077
Mailing address
1355 Edgewater St NW
Salem, OR 97304-4077
Phone (503) 588-6960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 031836 | Medicaid | OR |
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 |
|---|---|---|---|
| 5026 | OR | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crisdental Salem L.L.C. | General Practice | Past | Accepting new patients |
| William J. Blaumer | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Salem, OR
- NPI 1760741078
-
- Dentist
- Salem, OR
- NPI 1750526893
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228262400000",
"number": "1447258165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1355 EDGEWATER ST NW",
"city": "SALEM",
"state": "OR",
"postal_code": "973044077",
"telephone_number": "503-588-6960",
"fax_number": "503-365-0056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1355 EDGEWATER ST NW",
"city": "SALEM",
"state": "OR",
"postal_code": "973044077",
"telephone_number": "503-588-6960",
"fax_number": "503-365-0056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAUMER",
"first_name": "WILLIAM",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2008-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "5026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "031836",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.