The Buckley Dental Center PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

THE BUCKLEY DENTAL CENTER PC

Practice address

2325 Glenwood Ave SE
Atlanta, GA 30316-2362

Phone

(678) 800-8316

Fax

(678) 800-8317

NPI assigned

Oct 2, 2021

Organization subpart

No

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

Authorized official

Name

Elisha Elisha Buckley

Title

Owner

Phone

(678) 524-7364

Specialties & licenses 1

Addresses

Other names 1

• East Lake Family Dental Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elisha W. Buckley, D.D.S.

  • General Practice Dentistry
  • Roswell, GA
  • NPI 1811125651
  NPD
• Niariah Hope Fields, DDS

  • General Practice Dentistry
  • Douglasville, GA
  • NPI 1003548868
  NPD

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

{
    "created_epoch": "1633132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633132800000",
    "number": "1558033050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 WIGLEY RD NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300661503",
            "telephone_number": "678-524-7364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 GLENWOOD AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162362",
            "telephone_number": "678-800-8316",
            "fax_number": "678-800-8317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BUCKLEY DENTAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-02",
        "last_updated": "2021-10-02",
        "certification_date": "2021-10-02",
        "status": "A",
        "authorized_official_last_name": "BUCKLEY",
        "authorized_official_first_name": "ELISHA",
        "authorized_official_middle_name": "ELISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-524-7364"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Lake Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Body Well, LLC
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• The Bridges Center
• The Brookhaven Center for Counseling & Wellness
• The Burney Medical Group, LLC
• The Campbell Dental Group
• The Cataract Vision Institute LLC
• The Cavin Group, LLC
• The Center for Black Womens Wellness CBWW Inc

• Dental Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2021; 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.