Individual provider Active NPI

Brian Burke Blatter, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Concord, CA
National Provider Identifier
1750363602
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
39602 Issued in CA
Practice address
2189 East St
Concord, CA 94520-2011
Phone
(925) 685-3175
Fax
(925) 685-2695
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 39602 CA Primary

Addresses

Primary practice location

2189 East St
Concord, CA 94520-2011

Mailing address

2189 East St
Concord, CA 94520-2011
Phone (925) 685-3175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Dec 29, 2015 through Dec 29, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1750363602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2189 EAST ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202011",
            "telephone_number": "925-685-3175",
            "fax_number": "925-685-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2189 EAST ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202011",
            "telephone_number": "925-685-3175",
            "fax_number": "925-685-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATTER",
        "first_name": "BRIAN",
        "middle_name": "BURKE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CA",
            "license": "39602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.