Bryan Blazer, D.D.S.

Dentist · Joint Base Langley-Eustis, VA

Individual Active NPI

NPI number 1851677850

Practice location

77 Nealy Ave
633d Medical Group
Joint Base Langley-Eustis, VA 23665-2040
Phone
(764) 225-5039

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NPI record

NPI
1851677850
Entity type
Individual (Type 1)
Enumeration date
October 24, 2011
Last updated
October 24, 2011
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 019.028688 IL

About Dr. Blazer

Bryan Blazer, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 77 Nealy Ave, 633d Medical Group, Joint Base Langley-Eustis, VA 23665-2040. The NPI number 1851677850 was assigned on October 24, 2011 and the record was last updated on October 24, 2011.

Dr. Blazer lists a license in the registry: #019.028688 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Bryan Blazer, D.D.S.?

The NPI number is 1851677850.

What is the phone number of Dr. Blazer?

The phone number listed for the practice location is (764) 225-5039.

Where is Dr. Blazer located?

77 Nealy Ave, 633d Medical Group, Joint Base Langley-Eustis, VA 23665-2040.

What is the taxonomy code for Dr. Blazer?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.