Individual provider Active NPI

Ben Blumberg, DDS

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1982258372
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.025767 Issued in OH
Practice address
305 W 12TH Ave
Columbus, OH 43210-1267
Phone
(614) 688-3763
NPI assigned
Jul 24, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.025767 OH Primary

Addresses

Primary practice location

305 W 12TH Ave
Columbus, OH 43210-1267

Mailing address

1258 Pennsylvania Ave
Columbus, OH 43201-3125
Phone (937) 218-4932

Other practice location 1

613 Hebron Rd
Heath, OH 43056-1404
Phone (740) 788-8084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200723000570 OH Order and Referring Only - DentistPractitioner - Dentist 3678997632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.025767OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1982258372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 PENNSYLVANIA AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432013125",
            "telephone_number": "937-218-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W 12TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-688-3763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "613 Hebron Rd",
            "address_purpose": "LOCATION",
            "city": "Heath",
            "state": "OH",
            "postal_code": "430561404",
            "country_code": "US",
            "telephone_number": "740-788-8084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUMBERG",
        "first_name": "BEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-24",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.025767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.