Jared Thomas Buck, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DS 037976 Issued in PA

Practice address

1177 N Division St
Suite #1
Carson City, NV 89703-3874

Phone

(775) 883-3434

Fax

(775) 885-9985

NPI assigned

Jun 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 7, 2015 through May 7, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273622400000",
    "number": "1154525939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3953 BLAKE RD",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190062318",
            "telephone_number": "559-860-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 N DIVISION ST",
            "address_2": "SUITE #1",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897033874",
            "telephone_number": "775-883-3434",
            "fax_number": "775-885-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "JARED",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2010-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS 037976",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NV",
            "license": "S7-70C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce E Mullen a Professional Corporation
• Bryan L. Ricks, M.D.
• Mary K Bryan, MFT LADC NCAC
• Meracle Bryant
• Robin Buchheister
• Veatrice Marie Buckley
• Brooke Budman
• Charles L Buel, PH.D.
• Teresa Bugajski
• James H Burdick, MFT

• Endodontics in Carson City, NV
• Providers in Carson City, NV by specialty
• Endodontics in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.