Nicholas Busby, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

7414 Issued in OK

Practice address

1313 E 20TH St
Okmulgee, OK 74447-6303

Phone

(918) 591-5721

NPI assigned

May 25, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 2, 2025 through Dec 2, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nbusby20592@muscogeecreeknation.direct-ci.com

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.

• Apnea Breathing Clinic of Tulsa, PLLC

  • Dentist
  • Tulsa, OK
  • NPI 1083114516
  NPD (past)
• Terry R Bennett DMD Inc

  • Dentist
  • Tulsa, OK
  • NPI 1013201052
  NPD (past)

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1164097747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 E 20TH ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744476303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 E 20TH ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744476303",
            "telephone_number": "918-591-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSBY",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "7414",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "OK",
            "license": "7414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Jordan Bruner
• William Thomas Bryant, PH.D.
• Franchelle Burkhalter, RN
• Jamie Lynne Burney, LCSW
• Michael Keith Burnside, LPC, LADC
• Portia Lynn Butler
• Kylia Byassee
• Marquise Elzie Calhoun Jr.
• Braden Callister, DMD
• Campbell Chiropractic L.L.C.

• Public Health Dentistry in Okmulgee, OK
• Providers in Okmulgee, OK by specialty
• Public Health Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.