Dr Bryan Blazer, DDS is a medicare enrolled "Dentist" provider in Joint Base Langley-eustis, Virginia. His current practice location is
77 Nealy Ave, 633d Medical Group, Joint Base Langley-eustis, Virginia. You can reach out to his office (for appointments etc.) via phone at
(764) 225-5039.
Dr Bryan Blazer is licensed to practice in Illinois (license number 019.028688) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1851677850.
Healthcare Provider's Profile
| Full Name | Dr Bryan Blazer |
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| Gender | Male |
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| Speciality | Dentist |
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| Location | 77 Nealy Ave, Joint Base Langley-eustis, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1851677850
- Provider Enumeration Date: 10/24/2011
- Last Update Date: 10/24/2011
Medicare PECOS Information:
- PECOS PAC ID: 9931488236
- Enrollment ID: I20161109000637
Medical Identifiers
Medical identifiers for Dr Bryan Blazer such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1851677850 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 122300000X | Dentist | 019.028688 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Bryan Blazer is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Bryan Blazer, DDS
77 Nealy Ave, 633d Medical Group,
Joint Base Langley-eustis, VA 23665-2040
Ph: () - | Dr Bryan Blazer, DDS
77 Nealy Ave, 633d Medical Group,
Joint Base Langley-eustis, VA 23665-2040
Ph: (764) 225-5039 |
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