Fred Albert Bubernak, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

05126 Issued in VA

Practice address

1972 Opitz Blvd
Woodbridge, VA 22191-3304

Phone

(703) 494-2545

Fax

(703) 497-1272

NPI assigned

May 7, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fred a Bubernak DDS LTD

  • Dental Clinic/Center
  • Woodbridge, VA
  • NPI 1912110800
  NPD (past) Authorized official

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447463435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1972 OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913304",
            "telephone_number": "703-494-2545",
            "fax_number": "703-497-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1972 OPITZ BLVD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913304",
            "telephone_number": "703-494-2545",
            "fax_number": "703-497-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBERNAK",
        "first_name": "FRED",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "05126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charisma Bryant
• Kayla Bryant
• Madeline Florence Bryant
• Peter Alexander Bryce, M.D.
• Danielle Bubb, OTR/L
• Maria Bucciarelli
• Nina Buckley
• Katie Buckman, NP
• Peggy J Budnik, CFNP
• Adrienne Marie Buggs, MD

• General Practice Dentistry in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.