Jennifer Marie Buchanan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

35596 Issued in CA

Practice address

1601 2ND St
Suite 103 B
San Rafael, CA 94901-2712

Phone

(415) 460-1601

Fax

(415) 460-1606

NPI assigned

Mar 1, 2007

Sex

Female

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

Previously, effective Sep 1, 2016 through Sep 1, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jbuchanan249737@direct-ucsfmedicalcenter.org

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578691648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 SEQUOIA RD",
            "city": "FAIRFAX",
            "state": "CA",
            "postal_code": "949301552",
            "telephone_number": "415-457-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 2ND ST",
            "address_2": "SUITE 103 B",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012712",
            "telephone_number": "415-460-1601",
            "fax_number": "415-460-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "35596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Brunette, PSYD
• Ferris Kevin Bruton, MS, PPS
• Mary Kathleen Bryan, MFT
• Babs Bryant, M.S., C.C.C.
• Katherine Ann Buaron, DNP, PMHNP-BC
• Keely Brant Buchanan
• Alison Buck, MS
• Buckelew Program
• Buckelew Programs
• Buckelew Programs

• Dentist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Dentist in California

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.