Debra Blum, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

037082-1 Issued in NY

Practice address

10721 Queens Blvd
Suite 3
Forest Hills, NY 11375-4451

Phone

(718) 268-7400

Fax

(718) 739-3769

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Training Room LLC

  • Physical Therapist
  • Cherry Hill, NJ
  • NPI 1023108883
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629167325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 APPLEGREEN DR",
            "city": "OLD WESTBURY",
            "state": "NY",
            "postal_code": "115681202",
            "telephone_number": "516-484-3158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10721 QUEENS BLVD",
            "address_2": "SUITE 3",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754451",
            "telephone_number": "718-268-7400",
            "fax_number": "718-739-3769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "DEBRA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "037082-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00989437",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George Blikstein, PHARMACIST
• Audrey Paulette Blitz, RPH
• Daniel C Block, DDS
• Maria del Carmen Blondet de Gamarra
• Allison Bloom, MD
• Melissa Zellermaier Blum, M.A SLP
• BM Nurse Practitioner in Family Health PC
• Diane Boardman, M.A. CCC-SLP
• Jessica Bobadilla, WHNP
• Bodian Medical Services of Forest Hills PC

• Oral and Maxillofacial Surgery (Dentist) in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• 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.

Verify at the official NPI Registry.