1891781894 NPI number — DR. TIFFANY LYNNE BULLER-SCHUSSLER DDS

Table of content: DR. TIFFANY LYNNE BULLER-SCHUSSLER DDS (NPI 1891781894)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891781894 NPI number — DR. TIFFANY LYNNE BULLER-SCHUSSLER DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BULLER-SCHUSSLER
Provider First Name:
TIFFANY
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891781894
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
TIFFANY L. BULLER-SCHUSSLER DDS LLC DBA BELLBROOK DENTA
Provider Second Line Business Mailing Address:
4403 STATE ROUTE 725, SUITE C
Provider Business Mailing Address City Name:
BELLBROOK
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-848-8662
Provider Business Mailing Address Fax Number:
937-848-2317

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4403 STATE ROUTE 725
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
BELLBROOK
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-848-8662
Provider Business Practice Location Address Fax Number:
937-848-2317
Provider Enumeration Date:
09/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  12010111A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: 5541 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: 30-22095 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: 8558 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: 30.022095 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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