Individual provider Active NPI

Michael Bart Nussbaum, D.D.S.

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1508023342
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16292 Issued in TX
Practice address
3660 Stoneridge Rd
B101
Austin, TX 78746-7760
Phone
(512) 327-3631
Fax
(512) 327-2234
NPI assigned
May 20, 2008
Sex
Male
Sole proprietor
No

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.

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
16292TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Dental Sleep Services, PLLC Past Accepting new patients

NPPES NPI Registry

Updated by the provider on May 20, 2008

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 16292 TX Primary

Addresses

Primary practice location

3660 Stoneridge Rd
B101
Austin, TX 78746-7760

Mailing address

3660 Stoneridge Rd
B101
Austin, TX 78746-7760
Phone (512) 327-3631

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1508023342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 STONERIDGE RD",
            "address_2": "B101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787467760",
            "telephone_number": "512-327-3631",
            "fax_number": "512-327-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 STONERIDGE RD",
            "address_2": "B101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787467760",
            "telephone_number": "512-327-3631",
            "fax_number": "512-327-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "MICHAEL",
        "middle_name": "BART",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.