Organization Active NPI

Buffalo Dental Group PA

  • Dentist
  • Buffalo, MN
National Provider Identifier
1003004334
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BUFFALO DENTAL GROUP PA
Practice address
1000 Highway 25 South
Buffalo, MN 55313
Phone
(763) 682-2363
Fax
(763) 682-3706
NPI assigned
Oct 11, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mark T Pokorney, DDSNPI 1265597058
Title
Vice President
Phone
(763) 682-2363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Locations

1000 Highway 25 S
Buffalo, MN 55313
Phone (763) 682-2363

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X MN Primary

Addresses

NPPES NPI Registry

Primary practice location

1000 Highway 25 South
Buffalo, MN 55313

Mailing address

1000 Highway 25 South
Buffalo, MN 55313
Phone (763) 682-2363

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 11, 2007.

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1003004334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HIGHWAY 25 SOUTH",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "55313",
            "telephone_number": "763-682-2363",
            "fax_number": "763-682-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HIGHWAY 25 SOUTH",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "55313",
            "telephone_number": "763-682-2363",
            "fax_number": "763-682-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUFFALO DENTAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "POKORNEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "763-682-2363",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.