Daniel R. Blazo, DDS, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DANIEL R. BLAZO, DDS, PLLC

Practice address

22100 Outer Dr
Dearborn, MI 48124-3932

Phone

(313) 563-5855

NPI assigned

Jun 22, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Blazo, DDSNPI 1518316306

Title

Owner

Phone

(313) 505-0985

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Blazo, D.D.S

  • Dentist
  • Dearborn, MI
  • NPI 1518316306
  NPD Authorized official
• Gary Claude Veraghen, D.D.S.

  • Dentist
  • Dearborn, MI
  • NPI 1306971478
  NPD
• Brian Michael Long, D.D.S.

  • General Practice Dentistry
  • Dearborn, MI
  • NPI 1265503585
  NPD (past)

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1740859867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22100 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243932",
            "telephone_number": "313-563-5855",
            "fax_number": "313-563-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22100 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243932",
            "telephone_number": "313-563-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL R. BLAZO, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "BLAZO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-505-0985",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashonna Daley
• Malaysia Dallas
• Lucetry Dalton-Trusty, PSY.D.
• Nada Damli
• Alex Dandashly, DPM
• Daniel Salama DPM PC
• Brittany Marie Daniels
• Heaven Daniels
• Kayla Marie Daniels
• Kelly M Daniels, M.S., BCBA

• Dental Clinic/Center in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.