Brian Anthony Buccellato, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN-10225 Issued in CO

Practice address

7730 N Union Blvd
Suite 101
Colorado Springs, CO 80920-4084

Phone

(719) 536-0599

Fax

(719) 522-0396

NPI assigned

Nov 23, 2010

Last updated

Oct 2, 2016By the provider in NPPES

Sex

Male

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

Enrolled in CO

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brian Buccellato DDS, a PC

  dba Alpine Dentistry

  • General Practice Dentistry
  • Colorado Springs, CO
  • NPI 1255880100
  NPD Authorized official
• Jon Matthes DDS PC

  • Dentist
  • Colorado Springs, CO
  • NPI 1063847358
  NPD (past)

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475366400000",
    "number": "1780986794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7730 N UNION BLVD",
            "address_2": "SUITE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204084",
            "telephone_number": "719-536-0599",
            "fax_number": "719-522-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7730 N UNION BLVD",
            "address_2": "SUITE 101",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809204084",
            "telephone_number": "719-536-0599",
            "fax_number": "719-522-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCCELLATO",
        "first_name": "BRIAN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-23",
        "last_updated": "2016-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN-10225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Brynestad-Heuser, DC
• BSLC II
• Bstill Integrative Counseling Inc
• Amarise Buanteo
• Naomi Bubeck
• Kimberly Ann Buchanan, PTA
• Kodi Buchanan
• Steven Matthew Buchanan, OD
• Emily Kathryn Buche, OT
• Erica L Bucher, MOTR

• General Practice Dentistry in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.