Dentists at Buckeye Commons, LLP

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTISTS AT BUCKEYE COMMONS, LLP

Practice address

20650 W Roosevelt Street
Suite 111
Buckeye, AZ 85326

Phone

(480) 347-0780

NPI assigned

Aug 27, 2025

Last updated

Aug 27, 2025By 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

Lane Medina

Title

Owner

Phone

(714) 845-8500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1821977729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660041",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20650 W ROOSEVELT STREET",
            "address_2": "SUITE 111",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "85326",
            "telephone_number": "480-347-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTS AT BUCKEYE COMMONS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "LANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-845-8500"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rae Jean De Leon Ferguson
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• Matthew Ryan Denton, PT, DPT
• Megan E Desrochers, CPM LM
• Destiny Sober Living
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• Deveruex (Adult Foster Care Provider)

• General Practice Dentistry in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.