Michael Mark Blicher, D.D.S.
Individual provider Active NPI General Practice Dentistry · Washington, DC
NPI 1952464083 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1952464083
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DEN 3363 (DC)
- Practice address
- 1522 K St NW
Suite LL-1
Washington, DC 20005-1202 - Phone
- (202) 638-5400
- Fax
- (202) 842-0382
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150617002277 | DC | Order and Referring Only - Oral Surgery |
4789995796 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN 3363 | DC | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN 3363 | DC | Yes |
Addresses
Primary practice location
1522 K St NW
Suite LL-1
Washington, DC 20005-1202
Mailing address
1522 K St NW
Suite LL-1
Washington, DC 20005-1202
Phone (202) 638-5400
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.