Garrett Blundell, D.D.S., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

24945 Issued in TX

Practice address

1505 Emerald PLZ
College Station, TX 77845-1501

Phone

(979) 764-7101

Fax

(979) 764-7115

NPI assigned

Sep 4, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial SurgeryAlso: Oral Surgery

Education

University of Texas HSC at Houston School of Dentistry, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brazos Valley Oms PLLCGroup PAC ID 3173943651, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Brazos Valley Oms PLLC

  • Dentist
  • College Station, TX
  • NPI 1194931303
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375747200000",
    "number": "1891044012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 EMERALD PLZ",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778451501",
            "telephone_number": "979-764-7101",
            "fax_number": "979-764-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EMERALD PLZ",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778451501",
            "telephone_number": "979-764-7101",
            "fax_number": "979-764-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUNDELL",
        "first_name": "GARRETT",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-04",
        "last_updated": "2013-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "24945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Alysse Blewett
• Amy Kathryn Blok, CRNA
• Amanda Bloomberg, OD
• Leslie Bloomer, CCC-SLP
• Paula Renae Blume, PT
• Heidemarie W. Boas, NP
• Renny Boase
• Lawrence Boatman, LMT, PTA
• Jack L. Bodden, P.H.D.
• Allison Faye Boehm, LMT

• Oral and Maxillofacial Surgery (Dentist) in College Station, TX
• Providers in College Station, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; 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.

Verify at the official NPI Registry.