Leah Liddle Blitz, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

056790 Issued in NY

Practice address

3136 U.S. Route 11
Lisle, NY 13797

Phone

(607) 692-4987

NPI assigned

Feb 24, 2013

Sex

Female

Sole proprietor

No

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.

• Leah L. Blitz DMD, PLLC

  • General Practice Dentistry
  • Lisle, NY
  • NPI 1710762885

  General Practice

  NPD Authorized official
• Blitz Family Dental, LLC

  • Dental Clinic/Center
  • Bainbridge, NY
  • NPI 1831513548
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 23, 2023.

{
    "created_epoch": "1361664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1811237167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3136 U.S. ROUTE 11",
            "city": "LISLE",
            "state": "NY",
            "postal_code": "13797",
            "telephone_number": "607-341-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3136 U.S. ROUTE 11",
            "city": "LISLE",
            "state": "NY",
            "postal_code": "13797",
            "telephone_number": "607-692-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLITZ",
        "first_name": "LEAH",
        "middle_name": "LIDDLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-24",
        "last_updated": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "056790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi L Craft, LPN
• Daniel J. Driscoll, M.D.
• Hailey E Hill, LPN
• Heather Suzzanne Jones, LPN
• Leah L. Blitz DMD, PLLC

• All providers in Lisle, NY
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.