Charles Buchanan Drew, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D- 1701 Issued in ID

Practice address

1010 E Main St
Burley, ID 83318-2045

Phone

(208) 678-5597

NPI assigned

Sep 3, 2009

Last updated

Sep 3, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Buck Drew Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1346473550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 899",
            "address_2": "2100 B WARM SPRINGS ROAD",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "833400899",
            "telephone_number": "208-726-7897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E MAIN ST",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182045",
            "telephone_number": "208-678-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREW",
        "first_name": "CHARLES",
        "middle_name": "BUCHANAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-03",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D- 1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BUCK",
            "last_name": "DREW",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dennis Michaelson D.M.D., Ms
• Matthew David Detemple, D.O.
• Cami Dixon, RDN
• Mark A Dowdle, MD
• Dr. Brent S. Banner
• Oliver Joseph Droefenu, PHARMD
• Trevor Dschaak
• Mark Lee Dunlap, N.D., C.A.C., L.M.T
• Tyler Earl, COTA/L
• Deneb Edwards, M.T.

• Dentist in Burley, ID
• Providers in Burley, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.