Eric P. Buetow, D.D.S., P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

523 Issued in AK

Legal business name

ERIC P. BUETOW, D.D.S., P.C.

Practice address

2933 Horseshoe Way
North Pole, AK 99705-6122

Phone

(907) 488-0861

NPI assigned

Oct 15, 2007

Last updated

Oct 15, 2007By 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

Kathleen Madden

Title

Office Administrator

Phone

(907) 488-0861

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric P Buetow, DDS

  • Dentist
  • North Pole, AK
  • NPI 1174695803
  NPD (past)

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1861681959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56258",
            "city": "NORTH POLE",
            "state": "AK",
            "postal_code": "997051258",
            "telephone_number": "907-488-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 HORSESHOE WAY",
            "city": "NORTH POLE",
            "state": "AK",
            "postal_code": "997056122",
            "telephone_number": "907-488-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC P. BUETOW, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "MADDEN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "907-488-0861"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DDO523",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in North Pole, AK
• Providers in North Pole, AK by specialty
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.