Mark D Bucci, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

0401413415 Issued in VA

Practice address

11828 Fishing Point Dr
Suite 100
Newport News, VA 23606-4500

Phone

(757) 595-0496

Fax

(757) 595-0495

NPI assigned

Dec 12, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 25, 2016 through Oct 25, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1467720979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11828 FISHING POINT DR",
            "address_2": "SUITE 100",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064500",
            "telephone_number": "757-595-0496",
            "fax_number": "757-595-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11828 FISHING POINT DR",
            "address_2": "SUITE 100",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064500",
            "telephone_number": "757-595-0496",
            "fax_number": "757-595-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCI",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-12",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "VA",
            "license": "0401413415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleanor Bryant, LPC
• Emma Bryant
• Sterling Bryant
• Teleace Bryant, M.A., LMHP
• Richard Raymond Brzeski, MD
• Nicole M Buccieri-Aldridge, SPEECH-LANGUAGE PATH
• Andrew Christian Buchholz, DO
• Emily Margaret Buck, MSN, APRN, FNP-BC
• Stacie Lynn Buck, DPM
• Tikeama Buckingham, FNP-BC

• Prosthodontics in Newport News, VA
• Providers in Newport News, VA by specialty
• Prosthodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.