NPIMap

Organization Active NPI

Irving M Blau DDS & Richard a Kirsch DDS PC

  • Dentist
  • Dearborn HTS, MI
National Provider Identifier
1689829913
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12216 Issued in MI
Legal business name
IRVING M BLAU DDS & RICHARD A KIRSCH DDS PC
Practice address
24415 W Warren St
Dearborn HTS, MI 48127-2223
Phone
(313) 278-4470
Fax
(313) 278-0124
NPI assigned
Dec 1, 2008
Last updated
Dec 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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

Authorized official

Name
Dr. Irving M Blau, DDSNPI 1366545527
Title
Partner
Phone
(313) 278-4470

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9971 MI
Dentist 122300000X 12216 MI Primary

Addresses

Primary practice location

24415 W Warren St
Dearborn HTS, MI 48127-2223

Mailing address

24415 W Warren St
Dearborn HTS, MI 48127-2223
Phone (313) 278-4470

Other identifiers 2

IdentifierTypeStateIssuer
4049912MedicaidMI
4006263MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
Kirsch Blau DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

24415 W Warren St
Dearborn Hts, MI 48127
Phone (313) 278-4470

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228089600000",
    "number": "1689829913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24415 W WARREN ST",
            "city": "DEARBORN HTS",
            "state": "MI",
            "postal_code": "481272223",
            "telephone_number": "313-278-4470",
            "fax_number": "313-278-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24415 W WARREN ST",
            "city": "DEARBORN HTS",
            "state": "MI",
            "postal_code": "481272223",
            "telephone_number": "313-278-4470",
            "fax_number": "313-278-0124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVING M BLAU DDS & RICHARD A KIRSCH DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A",
        "authorized_official_last_name": "BLAU",
        "authorized_official_first_name": "IRVING",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "313-278-4470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "9971",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "12216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4049912",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4006263",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn HTS, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.