Scott Buckner, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901016855 Issued in MI

Practice address

124 Pearl St Ste 207
Ypsilanti, MI 48197-5375

Phone

(734) 481-0180

NPI assigned

Oct 24, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Ypsilanti Family & Cosmetic Dentistry

  • General Practice Dentistry
  • Ypsilanti, MI
  • NPI 1164533204
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871677013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 PEARL ST STE 206",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481975374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 PEARL ST STE 207",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481975375",
            "telephone_number": "734-481-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901016855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew James Brunelle, CRNA
• Angela Frances Bruski
• Belinda R Bryan, LLPC
• Kenneth John Buchanan, M.D.
• Elizabeth Buckmaster
• Michelle N Bucur, DEM
• Shajal Bufalini, PHARMD
• Colleen Deanne Bullard, DDS
• Kelsey Bulloch, PA-C
• Jade Burch

• General Practice Dentistry in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.