Henry A Blom, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

038462 Issued in NY

Practice address

10 Studio Arc
Bronxville, NY 10708-2631

Phone

(914) 337-1157

Fax

(914) 337-1165

NPI assigned

Apr 17, 2007

Sex

Male

Sole proprietor

Yes

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 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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669698932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 CROWS NEST RD",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107084816",
            "telephone_number": "914-337-1157",
            "fax_number": "914-337-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 STUDIO ARC",
            "city": "BRONXVILLE",
            "state": "NY",
            "postal_code": "107082631",
            "telephone_number": "914-337-1157",
            "fax_number": "914-337-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOM",
        "first_name": "HENRY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "038462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edwin Benitez, PA-C
• William Betancourt Jr., ED
• Joy Ann Bieder
• Biometric Solutions Center 7
• Ryan Blinn, PA-C
• Valeria Buckner Bobbin, MSE-MS-CCC/L
• John A. Bobinski, DDS
• Steven R Bodine, M.D.
• Matthew Bollati, PT, DPT
• Marzena M. Bona, M.D.

• General Practice Dentistry in Bronxville, NY
• Providers in Bronxville, NY by specialty
• General Practice Dentistry 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.
• 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.