Blum-Nico Oral Facial Surgery Associates, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

L11000065863 Issued in FL

Legal business name

BLUM-NICO ORAL FACIAL SURGERY ASSOCIATES, PLLC

Practice address

4308 Alton Rd Ste 850
Miami Beach, FL 33140-4558

Phone

(305) 538-4556

Fax

(305) 538-2019

NPI assigned

Oct 19, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jeffery D. Blum, DENTIST

Title

Owner

Phone

(305) 538-4556

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1467737684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 ALTON RD STE 850",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331404558",
            "telephone_number": "305-538-4556",
            "fax_number": "305-538-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4308 ALTON RD STE 850",
            "city": "MIAMI BEACH",
            "state": "FL",
            "postal_code": "331404558",
            "telephone_number": "305-538-4556",
            "fax_number": "305-538-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUM-NICO ORAL FACIAL SURGERY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-19",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-538-4556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DENTIST"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "L11000065863",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "L11000065863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Bleser, R.PH.
• Daphne Blodgett
• Michael L Bloom, M.D.
• Blue ABA Florida LLC
• Blum Surgical Associates, LLC
• Jeffrey Dennis Blum, D.D.S.
• Rachel Joy Blumberg, DO
• BMC Primary Care Solutions
• Joanah C Bodero, P.A.
• Sara M Bodner, MD

• Oral and Maxillofacial Surgery (Dentist) in Miami Beach, FL
• Providers in Miami Beach, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; 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.