DR. STEPHEN DALE BUCKLEW (NPI# 1669609939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669609939 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN DALE BUCKLEW |
| Credential | D.D.S. |
| Practice Address |
1100 Gum Branch Rd Jacksonville NC 28540-5743 |
| Practice Telephone | 9103472051 |
| Practice Fax Number | 9103477652 |
| Mailing Telephone | 9103472051 |
| Mailing Fax Number | 9103477652 |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2009-06-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 2505 | WV | Dental Providers |
| Y | 122300000X | Dentist | 4882 | NC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BLUE CROSS BLUE SHIELD | 91160 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528472826 | Stephen Paul Bucklew | General Practice | 4500 9th Ave Ne, Suite 375, Seattle, WA 98105-4737 | 2014-06-13 |
| Street Address |
1100 GUM BRANCH RD |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28540-5743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235377078 | Gregory Michael Wohlgemuth | Dentist | 1100 Gum Branch Rd, Jacksonville, NC 28540-5743 | 2009-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467067785 | Knox Counseling and Consulting, PC | Case Management | 513 New Bridge St-suite 500, Jacksonville, NC 28540 | 2020-09-14 |
| 1629696646 | Mary Ann Caldwell | Counselor | 2496 Northwoods Dr., Jacksonville, NC 28540 | 2020-07-07 |
| 1639793748 | Johnathon T Brewer | Military Health Care Provider | 100 White St, Jacksonville, NC 28540 | 2020-06-04 |
| 1043782899 | Brice Rivra | Military Health Care Provider | Rr 612 Loop Road, Jacsksonvile, NC 28540 | 2018-12-18 |
| 1649768599 | Alexander John Pybus | Student in an Organized Health Care Education/Training Program | White St Bldg As-100, Jacksonville, NC 28540 | 2018-04-26 |
| 1881198182 | Orleiquis Guerra | Military Health Care Provider | Marine Corps Air Station New River Bldg As-100, Jacksonville, NC 28540 | 2018-03-21 |
| 1558864736 | Andrew Louis Monroe | General Practice | As-100 White Street, Jacksonville, NC 28540 | 2018-03-14 |
| 1588183198 | Citizen Community Transport, LLC | Private Vehicle | 220 Foxwood Ct., Jacksonville, NC 28540 | 2017-09-14 |
| 1558886242 | Brandon Jay Smith | Military Health Care Provider | E Street Bldg G770, Camp Lejeune, NC 28540 | 2017-08-03 |
| 1174043244 | Jason Waters | Military Health Care Provider | White St, Bldg As-100, Jacksonville, NC 28540 | 2017-06-21 |
| Find all providers in zip 28540 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902419864 | Andre M Fang | Dentist | 6801 Roosevelt Blvd, Jacksonville, FL 32212-1192 | 2020-08-28 |
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1093323479 | Britney Marie Cruz | Dentist | 1280 Western Blvd Unit 200, Jacksonville, NC 28546-7658 | 2020-07-21 |
| 1083238786 | Sleep Better Solutions LLC | Dentist | 4215 Southpoint Blvd Ste 240, Jacksonville, FL 32216-0932 | 2020-05-29 |
| 1114550258 | James Moran | Dentist | 7990 Baymeadows Rd E # 718, Jacksonville, FL 32256-2961 | 2020-02-18 |
| 1265075329 | Latoya Goins | Dentist | 1280 Western Blvd, Jacksonville, NC 28546-6653 | 2019-10-22 |
| 1437706462 | Stephanie Marquez | Dentist | 751 Oak St Ste 601, Jacksonville, FL 32204-3373 | 2019-08-23 |
| 1831751064 | Rachel Marie Schloth | Dentist | 12086 Fort Caroline Rd Ste 105, Jacksonville, FL 32225-2688 | 2019-07-09 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1235796954 | Carolina Garcia | Dentist | 790 Skymarks Dr Ste 109, Jacksonville, FL 32218-7267 | 2019-05-29 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28540 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.