Individual provider Active NPI

Bao Truc Sybo

  • Dentist
  • Nashville, TN
National Provider Identifier
1013574284
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
23587 Issued in FL
Practice address
4502 Charlotte Pike
Nashville, TN 37209
Phone
(615) 933-1981
NPI assigned
May 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 23587 FL Primary
Dentist 122300000X 11157 TN

Addresses

Primary practice location

4502 Charlotte Pike
Nashville, TN 37209

Mailing address

1400 Rosa L Parks Blvd Apt 217
Nashville, TN 37208-2571
Phone (504) 723-4028

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23587FLMDDentist
11157TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists of Bellevue, PC Dentist Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1013574284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 ROSA L PARKS BLVD APT 217",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372082571",
            "telephone_number": "504-723-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 CHARLOTTE PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37209",
            "telephone_number": "615-933-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYBO",
        "first_name": "BAO TRUC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "23587",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "11157",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.