Provider Demographics
NPI:1942459862
Name:JAMES V. BARBUTO, DMD, PLLC
Entity Type:Organization
Organization Name:JAMES V. BARBUTO, DMD, PLLC
Other - Org Name:JAMES V. BARBUTO, DMD, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:VITO
Authorized Official - Last Name:BARBUTO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, PLLC
Authorized Official - Phone:724-375-2243
Mailing Address - Street 1:2496 BRODHEAD ROAD
Mailing Address - Street 2:SUITE D
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-4232
Mailing Address - Country:US
Mailing Address - Phone:724-375-2243
Mailing Address - Fax:724-857-0434
Practice Address - Street 1:2496 BRODHEAD ROAD
Practice Address - Street 2:SUITE D
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-4232
Practice Address - Country:US
Practice Address - Phone:724-375-2243
Practice Address - Fax:724-857-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024131L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA98884-DNTOtherUNISON
PA0007600OtherDORAL DENTAL
PA1021009750001Medicaid
PA106541OtherGATEWAY HEALTH AND UNITED CONCORDIA