Provider Demographics
NPI:1437255635
Name:BUCHANAN, ROXANNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROXANNA
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1984 RAILROAD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-3107
Mailing Address - Country:US
Mailing Address - Phone:925-456-7800
Mailing Address - Fax:925-456-7006
Practice Address - Street 1:1984 RAILROAD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-3107
Practice Address - Country:US
Practice Address - Phone:925-456-7800
Practice Address - Fax:925-456-7006
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA448381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice