Dental Arts Group L.L.C

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DENTAL ARTS GROUP L.L.C

Practice address

2700 Kanell Blvd
Poplar Bluff, MO 63901-3041

Phone

(573) 785-0111

NPI assigned

May 1, 2019

Last updated

Jan 27, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

DENTAL ARTS GROUP L.L.CAs reported in NPPES

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

Authorized official

Name

John R BlaichNPI 1548322936

Title

Dentist

Phone

(573) 785-0111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Part of

Dental Arts Group LLC

Locations

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.

• John R Blaich, D.M.D.

  • General Practice Dentistry
  • Poplar Bluff, MO
  • NPI 1548322936
  NPD Authorized official

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

{
    "created_epoch": "1556668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580083200000",
    "number": "1679138036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013041",
            "telephone_number": "573-785-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013041",
            "telephone_number": "573-785-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL ARTS GROUP L.L.C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL ARTS GROUP L.L.C",
        "enumeration_date": "2019-05-01",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A",
        "authorized_official_last_name": "BLAICH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "573-785-0111"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Deken
• Sabrina Deken
• Samantha Dellinger
• Dillon Demaree
• Jennifer Dennis, PHARM D
• Department of Veterans Affairs
• Dermatology Office PC (Elite Dermatology)
• Mary L Deschler, LCSW
• Robert L Dever, M.D.
• Sonya D Diciro, F.N.P.

• Durable Medical Equipment & Medical Supplies in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.