Philip T Buckler, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

28627 Issued in TX

Practice address

USA Dentac Fort Cavazos
3600 Shoemaker Lane, Suite 1051
Fort Cavazos, TX 76544

Phone

(503) 309-3715

NPI assigned

Nov 17, 2010

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 TX

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

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1871895219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "USA DENTAC FORT CAVAZOS",
            "address_2": "36000 SHOEMAKER LANE, SUITE 1051",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "503-309-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA DENTAC FORT CAVAZOS",
            "address_2": "3600 SHOEMAKER LANE, SUITE 1051",
            "city": "FORT CAVAZOS",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "503-309-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLER",
        "first_name": "PHILIP",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-17",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher M Brown, MSN, RN, LSS-LL
• Derek Brown, MD
• Nicole Hall Brown, DPT, OCS, SCS, TPS
• Treasure Ja'Leisha Zhane' Brown, DDS
• Tess Ann Brunstein, DDS
• Aaron P Burch, DO
• James Tristan Burdette, PA
• Abigail Burke, MD
• Nicole Burke
• Craig M Bush, MD

• Dentist in Fort Cavazos, TX
• Providers in Fort Cavazos, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.