Active NPI
Ryan Douglas Blissett, D.M.D.
- Prosthodontics
- Brookline, MA
National Provider Identifier
1972690691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 21630
- Practice address
- 1540 Beacon St
Brookline, MA 02446-2215 - Phone
- (617) 738-1950
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 21630 | MA | Primary |
Addresses
Primary practice location
1540 Beacon St
Brookline, MA 02446-2215
Mailing address
1540 Beacon St
Brookline, MA 02446-2215
Phone (617) 738-1950
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21630 | MA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243728000000",
"number": "1972690691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1540 BEACON ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024462215",
"telephone_number": "617-738-1950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 BEACON ST",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024462215",
"telephone_number": "617-738-1950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLISSETT",
"first_name": "RYAN",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2009-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MA",
"license": "21630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.