NPIMap

Organization Active NPI

Ezis & Blume DDS, Ms LLC

  • Periodontics
  • Cincinnati, OH
National Provider Identifier
1861688020
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
30-01-4284 Issued in OH
Legal business name
EZIS & BLUME DDS, MS LLC
Practice address
4030 Smith Rd
Suite 225
Cincinnati, OH 45209-1957
Phone
(513) 871-8488
Fax
(513) 871-8490
NPI assigned
Sep 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Authorized official

Name
Mrs. Beverly Dennis
Title
Business Manager
Phone
(513) 871-8488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 30-01-4284 OH Primary

Addresses

Primary practice location

4030 Smith Rd
Suite 225
Cincinnati, OH 45209-1957

Mailing address

4030 Smith Rd
Suite 225
Cincinnati, OH 45209-2207
Phone (513) 871-8488

National Provider Directory

National Provider Directory

Locations

4030 Smith Rd
Ste 225
Cincinnati, OH 45209
Phone (513) 748-6446

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1861688020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 SMITH RD",
            "address_2": "SUITE 225",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452092207",
            "telephone_number": "513-871-8488",
            "fax_number": "513-871-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 SMITH RD",
            "address_2": "SUITE 225",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091957",
            "telephone_number": "513-871-8488",
            "fax_number": "513-871-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EZIS & BLUME DDS, MS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "513-871-8488",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30-01-4284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.