Active NPI
Barry M Blitzstein, D.M.D.
- General Practice Dentistry
- Mantua, NJ
National Provider Identifier
1497957534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22D100843200
- Practice address
- 219 Twin Lakes Dr
Mantua, NJ 08051-1666 - Phone
- (856) 468-5635
- NPI assigned
- Jun 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 22D100843200 | NJ | Primary |
Addresses
Primary practice location
219 Twin Lakes Dr
Mantua, NJ 08051-1666
Mailing address
219 Twin Lakes Dr
Mantua, NJ 08051-1666
Phone (856) 468-5635
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 221852645000 | Other | FEDERAL IDENTIFICATION NO |
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 |
|---|---|---|---|
| 22D100843200 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497957534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 TWIN LAKES DR",
"city": "MANTUA",
"state": "NJ",
"postal_code": "080511666",
"telephone_number": "856-468-5635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 TWIN LAKES DR",
"city": "MANTUA",
"state": "NJ",
"postal_code": "080511666",
"telephone_number": "856-468-5635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLITZSTEIN",
"first_name": "BARRY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22D100843200",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL IDENTIFICATION NO",
"identifier": "221852645000",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Mantua, NJ
Sources for this page
- 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.