Active NPI
Blake Bufford
- Dentist
- Ann Arbor, MI
National Provider Identifier
1710463542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901022653
- Practice address
- 1011 N University Ave
Ann Arbor, MI 48109-1078 - Phone
- (734) 763-3326
- NPI assigned
- Jul 16, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901022653 | MI | MD | Dentist |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901022653 | MI | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
1011 N University Ave
Ann Arbor, MI 48109-1078
Mailing address
1011 N University Ave
Ann Arbor, MI 48109-1078
Phone (734) 763-3326
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 16, 2018.
{
"created_epoch": "1531699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531699200000",
"number": "1710463542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 N UNIVERSITY AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481091078",
"telephone_number": "734-763-3326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 N UNIVERSITY AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481091078",
"telephone_number": "734-763-3326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUFFORD",
"first_name": "BLAKE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-07-16",
"last_updated": "2018-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901022653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.