Buffalo Prairie Dental Care of Pittsfield, Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BUFFALO PRAIRIE DENTAL CARE OF PITTSFIELD, INC

Practice address

850 N Jackson St
Pittsfield, IL 62363-1206

Phone

(217) 285-4084

NPI assigned

Jan 2, 2008

Last updated

Jan 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Roy Glenn Northcutt, DMD

Title

Owner

Phone

(217) 285-4084

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199232000000",
    "number": "1760667307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N JACKSON ST",
            "city": "PITTSFIELD",
            "state": "IL",
            "postal_code": "623631206",
            "telephone_number": "217-285-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N JACKSON ST",
            "city": "PITTSFIELD",
            "state": "IL",
            "postal_code": "623631206",
            "telephone_number": "217-285-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUFFALO PRAIRIE DENTAL CARE OF PITTSFIELD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2008-01-02",
        "status": "A",
        "authorized_official_last_name": "NORTHCUTT",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-285-4084",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "0190242471",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Board of Trustees of Southern Illinois University (SIU Center for Family Medicine - Pittsfield)
• Joy Bockhold
• Jessica Nicole Boozer
• Borrowman Chiropractic LLC
• Jessica Ann Borrowman, D.C.
• Buffalo Prairie Dental Care, Inc
• Joanna Maureen Bunch, FNP-C
• Elizabeth Cannon, M.S., CFY-SLP
• Centerstone of Illinois, Inc
• Thomas A Cliatt, DO

• Dentist in Pittsfield, IL
• Providers in Pittsfield, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; 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.