Brian J. Blocher DDS SC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4002 Issued in WI

Legal business name

BRIAN J. BLOCHER DDS SC

Practice address

201 N Mayfair Rd Ste 520
Wauwatosa, WI 53226-4216

Phone

(414) 607-0222

Fax

(414) 607-0220

NPI assigned

Jul 22, 2010

Organization subpart

No

Name

Dr. Brian Joseph Blocher, DDS SC

Title

Owner/Oral Surgeon

Phone

(414) 607-0222

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 13, 2015.

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1699088369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N MAYFAIR RD STE 520",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264216",
            "telephone_number": "414-607-0222",
            "fax_number": "414-607-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N MAYFAIR RD STE 520",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264216",
            "telephone_number": "414-607-0222",
            "fax_number": "414-607-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN J. BLOCHER DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "BLOCHER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/ORAL SURGEON",
        "authorized_official_telephone_number": "414-607-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS   SC"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "4002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33683900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Wauwatosa, WI
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.