David Stanley Buczak, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21869 Issued in MA

Practice address

500 Columbia Rd
Dorchester, MA 02125-2322

Phone

(617) 287-8000

NPI assigned

Jul 6, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1265630644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 WASHINGTON ST APT 205",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252322",
            "telephone_number": "617-287-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCZAK",
        "first_name": "DAVID",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1301977",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• BT Chiropractic Health Center, Inc.
• Liana Buccieri, LICSW
• Nancy Bucken, RN
• Tyler Smith Buckhout, LICSW
• Ying Buckley, PA
• Vivian Bui, DPT
• Sharlene Teresa Bullock, LMHC
• Jessica Hart Burch
• Madeline Rose Burg, MSW
• Helen A Burgess, CNM

• General Practice Dentistry in Dorchester, MA
• Providers in Dorchester, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.