Kyle Edward Blau, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901020903 Issued in MI

Practice address

301 W Magnetic St
Marquette, MI 49855-2708

Phone

(906) 228-9333

NPI assigned

May 21, 2013

Sex

Male

Sole proprietor

No

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 MI

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marquette Family Dental PLLC

  • Dental Clinic/Center
  • Marquette, MI
  • NPI 1346714821
  NPD (past) Authorized official

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1720424443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10131 EMMA DRIVE",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "48326",
            "telephone_number": "906-280-7987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W MAGNETIC ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552708",
            "telephone_number": "906-228-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAU",
        "first_name": "KYLE",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-21",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Alysse Bitzer
• Jonathan Bjork, M.D.
• Nicole L Blaauw, PA-C
• Janet Lynn Blake
• Carol Blashill, RN
• Jennifer Lynne Bleckiner, CCC/SLP-L
• Kendra Sundin Bloom, BCBA, LBA
• Robert Howells Blotter, MD
• Stephanie Blubaugh, LCSW
• Cassie Bluhm, DO

• Dentist in Marquette, MI
• Providers in Marquette, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.