Active NPI
Mary Virginia Mayo Buckman, DDS
- Dentist
- Fayetteville, NC
National Provider Identifier
1891145546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10320
- Practice address
- 2500 Village Dr
Ste 101
Fayetteville, NC 28304-3748 - Phone
- (910) 487-0807
- Fax
- (910) 487-0389
- NPI assigned
- Jun 14, 2016
- Last updated
- Jun 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10320 | NC | Primary |
Addresses
Primary practice location
2500 Village Dr
Ste 101
Fayetteville, NC 28304-3748
Mailing address
2500 Village Dr
Ste 101
Fayetteville, NC 28304-3748
Phone (910) 487-0807
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 23, 2019 through Sep 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10320 | NC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joseph N. Catlett, Jr., D.D.S., P.a. | Past | Accepting new patients | |
| DRS. Turner & Butler DMD PA | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Durham, NC
- NPI 1700973930
-
- General Practice Dentistry
- Fayetteville, NC
- NPI 1457552259
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623110400000",
"number": "1891145546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 VILLAGE DR",
"address_2": "STE 101",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043748",
"telephone_number": "910-487-0807",
"fax_number": "910-487-0389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 VILLAGE DR",
"address_2": "STE 101",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043748",
"telephone_number": "910-487-0807",
"fax_number": "910-487-0389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKMAN",
"first_name": "MARY VIRGINIA",
"middle_name": "MAYO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-14",
"last_updated": "2021-06-08",
"certification_date": "2021-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "10320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.