Individual provider Active NPI

Joseph Buchalski, DMD

  • General Practice Dentistry
  • Jersey City, NJ
National Provider Identifier
1205005162
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
40 Journal SQ
Suite 325
Jersey City, NJ 07306-4009
Phone
(201) 216-0011
Fax
(210) 217-1070
NPI assigned
Feb 25, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NJ Primary

Addresses

Primary practice location

40 Journal SQ
Suite 325
Jersey City, NJ 07306-4009

Mailing address

40 Journal SQ
Suite 325
Jersey City, NJ 07306-4009
Phone (201) 216-0011

Other identifiers 1

IdentifierTypeStateIssuer
4591003MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160408001939 NJ Order and Referring Only - DentistPractitioner - Dentist 5496053316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DIO1789000NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1205005162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 JOURNAL SQ",
            "address_2": "SUITE 325",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064009",
            "telephone_number": "201-216-0011",
            "fax_number": "210-217-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 JOURNAL SQ",
            "address_2": "SUITE 325",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064009",
            "telephone_number": "201-216-0011",
            "fax_number": "210-217-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHALSKI",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-25",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4591003",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.