Active NPI
Daniel Bloom
- General Practice Dentistry
- Chandler, AZ
National Provider Identifier
1750020798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D011388
- Practice address
- 3042 W Queen Creek Rd
Chandler, AZ 85248-2815 - Phone
- (520) 796-2600
- Fax
- (602) 528-1255
- NPI assigned
- May 28, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D011388 | AZ | Primary |
Addresses
Primary practice location
3042 W Queen Creek Rd
Chandler, AZ 85248-2815
Mailing address
PO Box 38
Sacaton, AZ 85147-0001
Phone (602) 528-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dentist
- Education
- Midwestern University College of Dental Medicine, Glendale, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
483 W Seed Farm Rd
Sacaton, AZ 85147-5000
PO Box
Sacaton, AZ 85147
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D011388 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gila River Health Care | Past | Accepting new patients | |
| Scottsdale and Shea Dental Group, LLP | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Komatke Health Center
- Critical Access Hospital
- Laveen, AZ
- NPI 1376538231
TX
-
dba Thwajik Ke Outpatient Behavioral Health Services
- Community/Behavioral Health Agency
- Laveen, AZ
- NPI 1598021495
-
dba Scottsdale and Shea Dental Group
- Dentist
- Scottsdale, AZ
- NPI 1568846244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782172800000",
"number": "1750020798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 38",
"city": "SACATON",
"state": "AZ",
"postal_code": "851470001",
"telephone_number": "602-528-1200",
"fax_number": "602-528-1255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3042 W QUEEN CREEK RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852482815",
"telephone_number": "520-796-2600",
"fax_number": "602-528-1255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOM",
"first_name": "DANIEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-28",
"last_updated": "2026-06-23",
"certification_date": "2026-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D011388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.