Andrew Stephen Buckner

Primary specialty

DentistTaxonomy code 122300000X

License

2021019497 Issued in MO

Practice address

1508 NE 96TH St Ste a
Liberty, MO 64068-1396

Phone

(816) 415-5808

Fax

(816) 415-8083

NPI assigned

May 30, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Liberty Park Dental

  • Dentist
  • Liberty, MO
  • NPI 1588710552
  NPD (past)

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

{
    "created_epoch": "1622332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622332800000",
    "number": "1124694252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 N AMES AVE APT E",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641514859",
            "telephone_number": "417-214-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 NE 96TH ST STE A",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640681396",
            "telephone_number": "816-415-5808",
            "fax_number": "816-415-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "ANDREW",
        "middle_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-30",
        "last_updated": "2021-05-30",
        "certification_date": "2021-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2021019497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerad Bruggeman, ATC
• Deborah Bryant
• Jack Buchan
• Buckley Chiropractic, P.C.
• Eric J Buckley, D.C.
• Desiree Jade Buddemeyer
• Mackenzie Burch
• Tyler R Burch
• Cassie Marie Burgard
• Farah Rae Burgess

• Dentist in Liberty, MO
• Providers in Liberty, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2021; 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.