Active NPI
Robert Buda, D.D.S., M.S.
- Pediatric Dentistry
- Tukwila, WA
National Provider Identifier
1679692503
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Oct 20, 2021.
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DE00007787
- Practice address
- 411 Strander Blvd Ste 102
Tukwila, WA 98188-2961 - Phone
- (206) 575-1130
- Fax
- (206) 575-1133
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DE00007787 | WA | Primary |
Addresses
Primary practice location
411 Strander Blvd Ste 102
Tukwila, WA 98188-2961
Mailing address
411 Strander Blvd Ste 102
Tukwila, WA 98188-2961
Phone (206) 575-1130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5028758 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00007787 | WA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1679692503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 STRANDER BLVD STE 102",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981882961",
"telephone_number": "206-575-1130",
"fax_number": "206-575-1133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 STRANDER BLVD STE 102",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981882961",
"telephone_number": "206-575-1130",
"fax_number": "206-575-1133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUDA",
"first_name": "ROBERT",
"credential": "D.D.S., M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WA",
"license": "DE00007787",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5028758",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tukwila, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.