Daniel Blazo, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

2901021899 Issued in MI

Practice address

22100 Outer Dr
Dearborn, MI 48124-3932

Phone

(313) 563-5855

NPI assigned

Jun 13, 2016

Last updated

Jun 8, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Daniel R. Blazo, DDS, PLLC

  • Dental Clinic/Center
  • Dearborn, MI
  • NPI 1740859867
  NPD Authorized official
• Gary C. Veraghen, DDS, PC

  • General Practice Dentistry
  • Dearborn, MI
  • NPI 1417413360
  NPD

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1518316306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22100 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243932",
            "telephone_number": "313-563-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22100 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243932",
            "telephone_number": "313-563-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZO",
        "first_name": "DANIEL",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-13",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather M Blake, NNP
• Marie B Blanarova, CRNA
• Crystal Lynn Blanding, CNA
• Nimrod Blank, M.D.
• Joyce M Blazejewski, M.D.
• James C Blevins, BCBA, LBA
• Bloom Bridge Health
• Bloom Healthcare Management
• Bloom Hospice LLC
• Bloom Professional Services LLC

• Dentist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.