Individual provider Active NPI

Steven Michael Bleck, DDS

  • General Practice Dentistry
  • Williamsville, NY
National Provider Identifier
1609894310
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0441561 Issued in NY
Practice address
1321 Millersport Hwy
Suite 202
Williamsville, NY 14221-2900
Phone
(716) 631-0550
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0441561 NY Primary

Addresses

Primary practice location

1321 Millersport Hwy
Suite 202
Williamsville, NY 14221-2900

Mailing address

20 Nature Cove CT
Williamsville, NY 14221-1978
Phone (716) 639-7338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20151027000108 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4587973987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0441561NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609894310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NATURE COVE CT",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211978",
            "telephone_number": "716-639-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 MILLERSPORT HWY",
            "address_2": "SUITE 202",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212900",
            "telephone_number": "716-631-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLECK",
        "first_name": "STEVEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0441561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.