Individual provider Active NPI

Erik Blomquist, DDS

  • General Practice Dentistry
  • Saint Joseph, MI
National Provider Identifier
1548752959
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901600769 Issued in MI
Practice address
455 Upton Dr
Saint Joseph, MI 49085-1058
Phone
(269) 983-7888
NPI assigned
May 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901600769 MI Primary

Addresses

Primary practice location

455 Upton Dr
Saint Joseph, MI 49085-1058

Mailing address

PO Box 153
Douglas, MI 49406-0153

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

LicenseStateTypeSpecialty
2901600769MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kai Steele DDS PLLC CurrentSince Jul 17, 2021 Accepting new patients
Design Dental, Inc. Past Accepting new patients
Kai Steele DDS PLLC PastSince Jul 17, 2021 Accepting new patients

Locations

455 Upton Dr
Saint Joseph, MI 49085
Phone (269) 983-7881

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1548752959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 153",
            "city": "DOUGLAS",
            "state": "MI",
            "postal_code": "494060153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 UPTON DR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851058",
            "telephone_number": "269-983-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOMQUIST",
        "first_name": "ERIK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-31",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901600769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.