Individual provider Active NPI

Debra S Buckland

  • Dental Hygienist
  • Oneida, NY
National Provider Identifier
1083945067
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
51-019316 Issued in NY
Practice address
211 Broad Street
Oneida, NY 13421
Phone
(315) 797-3114
Fax
(315) 624-0474
NPI assigned
Jan 15, 2010
Last updated
Jan 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 51-019316 NY Primary

Addresses

Primary practice location

211 Broad Street
Oneida, NY 13421

Mailing address

2050 Tilden Ave
Box 1000
New Hartford, NY 13413-3613
Phone (315) 797-3114

Other identifiers 2

IdentifierTypeStateIssuer
00313539MedicaidNY
01815443MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
51-019316NYMDDental Hygienist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1083945067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 TILDEN AVE",
            "address_2": "BOX 1000",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134133613",
            "telephone_number": "315-797-3114",
            "fax_number": "315-624-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 BROAD STREET",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "13421",
            "telephone_number": "315-797-3114",
            "fax_number": "315-624-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLAND",
        "first_name": "DEBRA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "51-019316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00313539",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01815443",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneida, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; 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.