Active NPI
Kimberly Blaser, DDS
- Pediatric Dentistry
- Anthem, AZ
National Provider Identifier
1487847703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 5610
- Practice address
- 3618 W Anthem Way
Suite #D-104
Anthem, AZ 85086-0419 - Phone
- (623) 935-9873
- NPI assigned
- Aug 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5610 | AZ | Primary |
| Pediatric Dentistry | 1223P0221X | D-3495 | ID |
Addresses
Primary practice location
3618 W Anthem Way
Suite #D-104
Anthem, AZ 85086-0419
Mailing address
5016 W Hobby Horse Dr
Phoenix, AZ 85083-5452
Phone (623) 266-0243
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 |
|---|---|---|---|
| 5610 | AZ | MD | Internist Chiropractor |
| D-3495 | ID | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187568000000",
"number": "1487847703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5016 W HOBBY HORSE DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850835452",
"telephone_number": "623-266-0243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3618 W ANTHEM WAY",
"address_2": "SUITE #D-104",
"city": "ANTHEM",
"state": "AZ",
"postal_code": "850860419",
"telephone_number": "623-935-9873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLASER",
"first_name": "KIMBERLY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-20",
"last_updated": "2007-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "AZ",
"license": "5610",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "ID",
"license": "D-3495",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anthem, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.