Eileen Buckle, DDS
Individual provider Active NPI Pediatric Dentistry · Odenton, MD
NPI 1073779211 · NPPES record last updated Aug 28, 2024
Key facts
- NPI
- 1073779211
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 16121 (MD)
- Practice address
- 1215 Annapolis Rd Ste 205
Odenton, MD 21113-1346 - Phone
- (678) 982-5130
- NPI assigned
- Aug 6, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN014232 | GA | MD | Pediatric Dentist |
| 16121 | MD | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Dental Specialists | Current | Accepting new patients | |
| Pediatric Hospital Dentistry | Pediatric Dentistry | Current | Accepting new patients |
Locations
1215 Annapolis Rd
Ste 205
Odenton, MD 21113
Phone (443) 858-8377
Interoperability endpoints
- eileen.buckle.p1@direct.mcg-hhs.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN014232 | GA | |
| Pediatric Dentistry | 1223P0221X | 16121 | MD | Yes |
Addresses
Primary practice location
1215 Annapolis Rd Ste 205
Odenton, MD 21113-1346
Mailing address
1215 Annapolis Rd Ste 205
Odenton, MD 21113-1346
Phone (678) 982-5130
Other practice location 1
2526 Shallowford Rd Ste C
Marietta, GA 30066-3053
Phone (678) 813-0500
Other providers in Odenton, MD
- Keeonna Brown
- Micaela Simone Browne
- Desiree B Bruce
- Bradley Buabeng
- Edna Buckle
- Tanuja Budhathoki
- Kyra L Burden
- Cara Burgess
- Mikayla Butz
- Sarah Anne Caffey
All providers in Odenton, MD · Pediatric Dentistry in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.