Individual provider Active NPI

David Allen Buchanan, DMD

  • Dentist
  • Bowling Green, KY
National Provider Identifier
1093833923
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3668 Issued in KY
Practice address
546 Park St
Ste 100
Bowling Green, KY 42103
Phone
(270) 781-3133
Fax
(270) 846-0193
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 3668 KY
Dentist 122300000X 3668 KY Primary

Addresses

Primary practice location

546 Park St
Ste 100
Bowling Green, KY 42103

Mailing address

546 Park St
Ste 200
Bowling Green, KY 42103
Phone (270) 781-3133

Other identifiers 1

IdentifierTypeStateIssuer
60036688MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171206002189 KY Order and Referring Only - DentistPractitioner - Dentist 8527325166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1093833923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 PARK ST",
            "address_2": "STE 200",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42103",
            "telephone_number": "270-781-3133",
            "fax_number": "270-846-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 PARK ST",
            "address_2": "STE 100",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42103",
            "telephone_number": "270-781-3133",
            "fax_number": "270-846-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "KY",
            "license": "3668",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "3668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60036688",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.