Gregory Brussell, DMD

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

9847 Issued in KY

Practice address

919 Chambers Blvd
Bardstown, KY 40004-2573

Phone

(502) 348-6404

Fax

(502) 348-6342

NPI assigned

Aug 17, 2016

Last updated

Sep 8, 2020By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1548715758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 CHAMBERS BLVD",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400042573",
            "telephone_number": "502-348-6404",
            "fax_number": "502-348-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 CHAMBERS BLVD",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400042573",
            "telephone_number": "502-348-6404",
            "fax_number": "502-348-6342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 E Lincoln Trail Blvd",
            "address_purpose": "LOCATION",
            "city": "Radcliff",
            "state": "KY",
            "postal_code": "401601253",
            "country_code": "US",
            "telephone_number": "270-351-5858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUSSELL",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-17",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9847",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "KY",
            "license": "9847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Reid Brooks, P.T.
• Kaleena Marie Brown, MS, LPAT, ATR-BC
• Kersten Brown, RBT
• Shannen Brown, MS, ATC, LAT
• Kelli Marie Bruington, M.ED., BCBA, LBA
• Vickie Lynn Bryan, IECE
• Jonathan Ashley Buckman, PHARM D
• Devin Matthew Buley
• Sherri Bunch, ARNP
• Jaden Grace Burba

• Public Health Dentistry in Bardstown, KY
• Providers in Bardstown, KY by specialty
• Public Health Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.