Marietta Bufalino, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019019069 Issued in IL

Practice address

4005 1/2 Algonquin Rd
Rolling Meadows, IL 60008-3001

Phone

(847) 397-6060

NPI assigned

Apr 14, 2014

Last updated

Feb 3, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Practice roles

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.

• Marietta a Bufalino Inc

  • General Practice Dentistry
  • Rolling Meadows, IL
  • NPI 1952453979
  NPD (past) Authorized official

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1972922433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 1/2 ALGONQUIN RD",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600083001",
            "telephone_number": "847-397-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 1/2 ALGONQUIN RD",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600083001",
            "telephone_number": "847-397-6060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFALINO",
        "first_name": "MARIETTA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019019069",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019019069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandice Marie Brazell, P.A
• Bridget Gregory Pileggi (Chicago Counseling Collaborative)
• Chantal Brobst, MS, OTR/L
• Brookdale Hospice, LLC (Brookdale Hospice)
• Robyn Lyn Brownell, MD
• Michael Bukhalo, MD
• Demetrio Hamoy Bustalino
• Jasmine Jenny Bustamante, MSCMHC
• Robyn Nicole Calvelo
• Thomas Campbell, DPM

• Dentist in Rolling Meadows, IL
• Providers in Rolling Meadows, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.