NPIMap

Organization Active NPI

Southway Family Dentistry

  • General Practice Dentistry
  • Muncie, IN
National Provider Identifier
1902154248
Registry record updated Aug 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009906A Issued in IN
Legal business name
SOUTHWAY FAMILY DENTISTRY
Practice address
3745 S Madison St
Muncie, IN 47302-5756
Phone
(765) 896-9857
Fax
(765) 896-9937
NPI assigned
Aug 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David M Buksar, DDSNPI 1649252891
Title
Owner
Phone
(765) 896-9857

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12009906A IN Primary

Addresses

Primary practice location

3745 S Madison St
Muncie, IN 47302-5756

Mailing address

3745 S. Madison St
Muncie, IN 47302-5756
Phone (765) 896-9857

National Provider Directory

National Provider Directory

Locations

3745 S Madison St
Muncie, IN 47302
Phone (765) 896-9857

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1345075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345075200000",
    "number": "1902154248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3745 S. MADISON ST",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473025756",
            "telephone_number": "765-896-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 S MADISON ST",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473025756",
            "telephone_number": "765-896-9857",
            "fax_number": "765-896-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWAY FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-16",
        "last_updated": "2012-08-16",
        "status": "A",
        "authorized_official_last_name": "BUKSAR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-896-9857",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009906A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; 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.