Kim Buckles, DH
Individual provider Active NPI Dental Hygienist · Burwell, NE
NPI 1609136290 · NPPES record last updated May 17, 2012
Key facts
- NPI
- 1609136290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Hygienist 124Q00000X
- License
- 405 (NE)
- Practice address
- 934 I St
Burwell, NE 68823-0995 - Phone
- (308) 346-5795
- Fax
- (308) 346-9106
- NPI assigned
- May 17, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 405 | NE | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Loup Basin Public Health Department | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 405 | NE | Yes |
Addresses
Primary practice location
934 I St
Burwell, NE 68823-0995
Mailing address
PO Box 995
Burwell, NE 68823-0995
Phone (308) 346-5795
Other providers in Burwell, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.