Individual provider Active NPI

Jeffery Lowell Blume, D.D.S., DDS

  • Periodontics
  • Houston, TX
National Provider Identifier
1831240738
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
15386 Issued in TX
Practice address
17350 State Highway 249 Ste 340
Houston, TX 77064-1139
Phone
(281) 890-0095
Fax
(281) 890-7550
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 15386 TX Primary

Addresses

Primary practice location

17350 State Highway 249 Ste 340
Houston, TX 77064-1139

Mailing address

17350 Texas Hwy. 249, Suite #340
Houston, TX 77064-1139
Phone (281) 890-0095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15386TXMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831240738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17350 TEXAS HWY. 249, SUITE #340",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770641139",
            "telephone_number": "281-890-0095",
            "fax_number": "281-890-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17350 STATE HIGHWAY 249 STE 340",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770641139",
            "telephone_number": "281-890-0095",
            "fax_number": "281-890-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUME, D.D.S.",
        "first_name": "JEFFERY",
        "middle_name": "LOWELL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "15386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.