NPIMap

Organization Active NPI

Blew Family Dentistry, P.C.

  • Dentist
  • Moline, IL
National Provider Identifier
1548383169
Registry record updated Feb 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019024739 Issued in IL
Legal business name
BLEW FAMILY DENTISTRY, P.C.
Practice address
604 35TH Ave
Moline, IL 61265-6174
Phone
(309) 797-4336
NPI assigned
Apr 9, 2007
Last updated
Feb 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2011

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

Authorized official

Name
Dr. Bryan Christopher Blew, D.D.S.NPI 1568585164
Title
President
Phone
(309) 797-4336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019024739 IL Primary

Addresses

Primary practice location

604 35TH Ave
Moline, IL 61265-6174

Mailing address

604 35TH Ave
Moline, IL 61265-6174
Phone (309) 797-4336

National Provider Directory

National Provider Directory

Locations

604 35th Ave
Moline, IL 61265
Phone (309) 762-8445

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297296000000",
    "number": "1548383169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 35TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656174",
            "telephone_number": "309-797-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 35TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656174",
            "telephone_number": "309-797-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLEW FAMILY DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2011-02-10",
        "status": "A",
        "authorized_official_last_name": "BLEW",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-797-4336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019024739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.