DR. BLAKE JOSEPH HILDEBRAND DDS
NPI 1124719042
Student in an Organized Health Care Education/Training Program in Detroit, MI
About Dr. Blake Joseph Hildebrand Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. BLAKE JOSEPH HILDEBRAND DDS (NPI 1124719042) is an individual student in an organized health care education/training program in Detroit, Michigan, licensed in Michigan (2901601794) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Blake Joseph Hildebrand Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DETROIT, MI 48201
DETROIT, MI 48201
DETROIT, MI 48201
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Blake Hildebrand's NPI number?
The NPI number for Blake Hildebrand is 1124719042. It was assigned to this individual provider in the NPPES registry on May 19, 2023.
Where is Blake Hildebrand located?
Blake Hildebrand practices at 4201 Saint Antoine St, Detroit, MI 48201. The listed phone number is (313) 745-6302.
What is Blake Hildebrand's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Blake Hildebrand enrolled in Medicare?
Yes. Blake Hildebrand is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Blake Hildebrand was last updated on July 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Blake Joseph Hildebrand, DDS · NPI 1124719042
Student in an Organized Health Care Education/Training Program provider in Detroit, Michigan. Individual provider, active in the CMS NPPES registry since May 19, 2023.
## Identity
- **NPI:** 1124719042 (Entity type: Individual)
- **Enumerated:** May 19, 2023
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **State license:** 2901601794 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 4201 SAINT ANTOINE ST, Detroit, MI 48201-2153
- **Phone:** (313) 745-6302
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
## Record status
- **NPPES last updated:** July 25, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1124719042) · Data from the CMS NPPES public registry.