Active NPI
Elizabeth S Bujack, DDS MSD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Kent, OH
National Provider Identifier
1962670018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 30016399
- Practice address
- 121 N Depeyster St
Kent, OH 44240-2510 - Phone
- (330) 678-6111
- Fax
- (330) 673-6196
- NPI assigned
- Feb 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 30016399 | OH | Primary |
Addresses
Primary practice location
121 N Depeyster St
Kent, OH 44240-2510
Mailing address
121 N Depeyster St
Kent, OH 44240-2510
Phone (330) 678-6111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30016399 | OH | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202774400000",
"number": "1962670018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 N DEPEYSTER ST",
"city": "KENT",
"state": "OH",
"postal_code": "442402510",
"telephone_number": "330-678-6111",
"fax_number": "330-673-6196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 N DEPEYSTER ST",
"city": "KENT",
"state": "OH",
"postal_code": "442402510",
"telephone_number": "330-678-6111",
"fax_number": "330-673-6196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUJACK",
"first_name": "ELIZABETH",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DDS MSD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-12",
"last_updated": "2008-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "OH",
"license": "30016399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.