Individual provider Active NPI

Joshua Bussard

  • General Practice Dentistry
  • Ypsilanti, MI
National Provider Identifier
1215556741
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901601193 Issued in MI
Practice address
3785 Carpenter Rd
Ypsilanti, MI 48197-9809
Phone
(734) 272-4527
NPI assigned
Apr 14, 2020
Last updated
Feb 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12013573A IN
General Practice Dentistry 1223G0001X 2901601193 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X HI

Addresses

Primary practice location

3785 Carpenter Rd
Ypsilanti, MI 48197-9809

Mailing address

3785 Carpenter Rd
Ypsilanti, MI 48197-9809
Phone (734) 272-4527

Other practice location 1

4716 Illinois Rd Ste 101
Fort Wayne, IN 46804-5123
Phone (701) 720-3218

Other practice location 2

16-192 Pili Mua St
Keaau, HI 96749-8134
Phone (808) 333-3600

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
12013573AINMDDentist
2901601193MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
LPC Ypsi PLLC General Practice CurrentSince Feb 27, 2022 Accepting new patients

Locations

3785 Carpenter Rd
Ypsilanti, MI 48197
Phone (734) 202-7245

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1215556741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3785 CARPENTER RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481979809",
            "telephone_number": "734-272-4527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3785 CARPENTER RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481979809",
            "telephone_number": "734-272-4527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4716 Illinois Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468045123",
            "country_code": "US",
            "telephone_number": "701-720-3218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16-192 Pili Mua St",
            "address_purpose": "LOCATION",
            "city": "Keaau",
            "state": "HI",
            "postal_code": "967498134",
            "country_code": "US",
            "telephone_number": "808-333-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSSARD",
        "first_name": "JOSHUA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-14",
        "last_updated": "2022-02-25",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013573A",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901601193",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "HI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.