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Contact Information

JEFFREY T BLOOM, DDS
631 ST ANNE ST
SUITE 105
RAPID CITY, SD57701
 Phone: 605-343-6003
 Fax: 605-342-0998
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for JEFFREY T BLOOM · (Male)

NPI Number 1144392440
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 11/14/2006
Last updated 03/31/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • SD License # M660
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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