Johnny Roy Fuson, DDS – General Practice Dentistry

Key facts

NPI: 1003830837
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 30. 017343 (OH)
Practice address: 117 S Poplar St
Bucyrus, OH 44820-2209
Phone: (419) 562-9901
Fax: (419) 562-1460
NPI assigned: Jul 26, 2006
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Bucyrus Family Dentist Group General Practice Dentistry · Bucyrus, OH · NPI 1144667577

NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
30. 017343	OH	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Bucyrus Family Dentist Group	General Practice	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	30. 017343	OH	Yes

Addresses

Primary practice location

117 S Poplar St
Bucyrus, OH 44820-2209

Mailing address

117 S Poplar St
Bucyrus, OH 44820-2209
Phone (419) 562-9901

Other providers in Bucyrus, OH

All providers in Bucyrus, OH · General Practice Dentistry in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.