Individual provider Active NPI

Joseph G Bussell, D.D.S.

  • General Practice Dentistry
  • Columbia, MO
National Provider Identifier
1497942262
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2005030156 Issued in MO
Practice address
1 E Broadway
Columbia, MO 65203-4205
Phone
(573) 449-2858
NPI assigned
Sep 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2005030156 MO Primary

Addresses

Primary practice location

1 E Broadway
Columbia, MO 65203-4205

Mailing address

1 E Broadway
Columbia, MO 65203-4205
Phone (573) 449-2858

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005030156MOMDGeneral Practice Dentistry
2839ARMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph G. Bussell, DDS, PA CurrentSince Dec 1, 2009 Accepting new patients
Joseph G. Bussell, DDS PA General Practice Current Accepting new patients

Locations

6020 Ranch Dr
Ste C6
Little Rock, AR 72223
Phone (501) 868-1300

301 E Stadium
Magnolia, AR 71753
Phone (870) 234-9800

Organizations & group practices 2

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": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1497942262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034205",
            "telephone_number": "573-449-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034205",
            "telephone_number": "573-449-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSELL",
        "first_name": "JOSEPH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2005030156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; 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.