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BLACE MICHAEL HAVILAND DO
NPI 1245973304
Student in an Organized Health Care Education/Training Program in Dayton, OH

Active since April 17, 2022PECOS Enrolled
405 W GRAND AVE, DAYTON, OH 45405(937) 723-3245 Get Directions Write a Review

NPPES record last updated: April 17, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Blace Michael Haviland Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLACE MICHAEL HAVILAND DO (NPI 1245973304) is an individual student in an organized health care education/training program in Dayton, Ohio and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245973304
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBLACE MICHAEL HAVILANDCredential: DO
Location Address405 W GRAND AVEDayton, OH 45405-7538
Mailing Address405 W Grand AveDayton, OH 45405-7538 · (937) 723-3245
Phone(937) 723-3245
Sole ProprietorNo
Enumeration DateApril 17, 2022
NPPES CertifiedApril 17, 2022
✔ NPI 1245973304 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
405 W GRAND AVE, Dayton, OH 45405
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blace Michael Haviland Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

LARA MARTINEZ
Emergency Medicine
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3245
ANDREW JORDAN KRISTUFEK DO
Student in an Organized Health Care Education/Training Program
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3248
DR. JASON DWIGHT MCINTOSH D.O.
Emergency Medicine
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3248
WHITNEY J CRYE D.O.
Obstetrics & Gynecology
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3567
SARAH BLESCH
Nurse Anesthetist, Certified Registered
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3200
ALEXANDRA D BREZOVEC
Student in an Organized Health Care Education/Training Program
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3248
RONALD TRAN DO
Student in an Organized Health Care Education/Training Program
405 W GRAND AVE
DAYTON, OH 45405
Montgomery County (937) 723-3200
DR. CHARLES OSBORNE DUNCAN II DO
Internal Medicine
405 W GRAND AVE, C/O MEDICAL EDUCATION
DAYTON, OH 45405
Montgomery County (937) 723-3248

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 Blace Haviland's NPI number?

The NPI number for Blace Haviland is 1245973304. It was assigned to this individual provider in the NPPES registry on April 17, 2022.

Where is Blace Haviland located?

Blace Haviland practices at 405 W Grand Ave, Dayton, OH 45405. The listed phone number is (937) 723-3245.

What is Blace Haviland's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Blace Haviland enrolled in Medicare?

Yes. Blace Haviland is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Blace Haviland was last updated on April 17, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.