Elizabeth Corinne Buckley, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30022612 Issued in OH

Practice address

359 Front St
Suite 6
Berea, OH 44017

Phone

(440) 234-2813

Fax

(440) 234-7820

NPI assigned

Nov 23, 2007

Last updated

Mar 31, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Elizabeth Corinne Welfare Former name

Medicare fee-for-service enrollment

Enrolled in OH

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": "1195776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1982885638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 FRONT ST",
            "address_2": "SUITE 6",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "44017",
            "telephone_number": "440-234-2813",
            "fax_number": "440-234-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 FRONT ST",
            "address_2": "SUITE 6",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "44017",
            "telephone_number": "440-234-2813",
            "fax_number": "440-234-7820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "ELIZABETH",
        "middle_name": "CORINNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-23",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30022612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "WELFARE",
            "middle_name": "CORINNE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Salahudeen Brooks
• Shayla Marie Brooks
• Teante Brown Jones
• Ashley Brown, QMHS, CMS
• Browns Home Healthcare LTD
• Maria Buesking
• Bailey Paige Burgan, PA-C
• Burning River Home Services (Five Star Bath Solutions of Cleveland)
• Lavondra D Burrell
• Dazsha Bush

• General Practice Dentistry in Berea, OH
• Providers in Berea, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.