Kimberly Anne Buckner, D.M.D.

Individual provider Active NPI General Practice Dentistry · Sandy Hook, KY

NPI 1316080385 · NPPES record last updated Jan 26, 2021

Key facts

NPI
1316080385
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
7741 (KY)
Practice address
38 J F Green St
Sandy Hook, KY 41171-7134
Phone
(606) 738-5545
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7741KYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Kimberly a. Buckner, P.L.C. General Practice Current
since Feb 21, 2021
Accepting new patients

Locations

38 J F Green St
Sandy Hook, KY 41171
Phone (606) 738-5545

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7741 KY
General Practice Dentistry 1223G0001X 7741 KY Yes

Addresses

Primary practice location

38 J F Green St
Sandy Hook, KY 41171-7134

Mailing address

P.O. Box 85
Sandy Hook, KY 41171
Phone (606) 495-5245

Other practice location 1

Highway 7 & 32
Sandy Hook, KY 41171
Phone (606) 738-5545

Other practice location 2

265 KY Route 122
Martin, KY 41649
Phone (606) 949-6971

Other identifiers

IdentifierTypeStateIssuer
45002581OtherKYEPSDT ID
60000791MedicaidKY

Other providers in Sandy Hook, KY

All providers in Sandy Hook, KY · General Practice Dentistry in Kentucky

Sources for this page

Verify at the official NPI Registry.