Kelly Leigh Bussey, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

0401410052 Issued in VA

Practice address

477 Viking Dr
Sutie #215
Virginia Beach, VA 23452-7349

Phone

(757) 486-5428

Fax

(757) 486-4826

NPI assigned

Sep 19, 2007

Last updated

Sep 19, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 4, 2016 through Mar 4, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Chester Mayo DMD, P.C.

  dba Mayo Endodontics

  • Endodontics
  • Virginia Beach, VA
  • NPI 1942854922
  NPD (past)
• DRS Bussey Mayo & Archer LTD

  • Endodontics
  • Virginia Beach, VA
  • NPI 1760578637
  NPD (past)

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1538355011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 VIKING DR",
            "address_2": "SUTIE #215",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527349",
            "telephone_number": "757-486-5428",
            "fax_number": "757-486-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 VIKING DR",
            "address_2": "SUTIE #215",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527349",
            "telephone_number": "757-486-5428",
            "fax_number": "757-486-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSEY",
        "first_name": "KELLY",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401410052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamryn Paige Bush, MS
• Stacy Rae Bushey, LCSW
• Darren Buss, R.PH.
• Amy Bussey, CSAC, CSAC-S
• Elizabeth Bussey
• William Bussey, D.D.S.
• Ariane Joy Butangen
• Amy Denise Butler, RDN
• Annelore Fontane Butler, M.D.
• Arianna Butler

• Endodontics in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Endodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.