Stephen David Buck, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6274 Issued in WA

Practice address

310 Harvard Ave E
Seattle, WA 98102-5421

Phone

(206) 324-1100

Fax

(206) 324-6711

NPI assigned

Jan 25, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in WA

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Broadway Dental Center, Inc.

  dba S. David Buck, DDS

  • Dental Clinic/Center
  • Seattle, WA
  • NPI 1134509458
  NPD (past) Authorized official
• Richard Y Miyata DDS PLLC

  • Dentist
  • Seattle, WA
  • NPI 1477096238
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477609329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 HARVARD AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981025421",
            "telephone_number": "206-324-1100",
            "fax_number": "206-324-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HARVARD AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981025421",
            "telephone_number": "206-324-1100",
            "fax_number": "206-324-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "STEPHEN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "6274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Hernandez Buck, MD
• Julie M Buck, MD
• Laura Ingrid Buck, MD
• Maura Buck, LMP
• Michael Buck
• Taylor Buck
• Kyle Buckham, PT, DPT
• Sara Buckingham
• Sarah Buckingham, MSW
• Stephen Thomas Buckingham

• Dentist in Seattle, WA
• Providers in Seattle, WA by specialty
• Dentist in Washington

• 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.
• 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.