Individual provider Active NPI

Brian Sybo, DDS,MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Nashville, TN
National Provider Identifier
1669745899
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
11139 Issued in TN
Practice address
324 22ND Ave N
Nashville, TN 37203-1842
Phone
(615) 329-4401
NPI assigned
Feb 19, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 11139 TN Primary

Addresses

Primary practice location

324 22ND Ave N
Nashville, TN 37203-1842

Mailing address

324 22ND Ave N
Nashville, TN 37203-1842
Phone (615) 329-4401

Other practice location 1

125 Cool Springs Blvd Ste 120
Franklin, TN 37067-6475
Phone (615) 778-0902

Other names 1

  • Dr. Brian Sybo Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191111002581 TN Practitioner - Maxillofacial Surgery 6507298601 Reassigns benefits to 1 organization
I20231012001186 NY Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 6507298601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11139TNMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Surgical Institute, P.C. Oral and Maxillofacial Surgery CurrentSince Sep 26, 2019 Accepting new patients
Oral Surgical Institute, P.C. Single Specialty Past Accepting new patients

Locations

125 Cool Springs Blvd
Ste 120
Franklin, TN 37067
Phone (615) 778-0902

500 28th Ave N
Ste 100
Nashville, TN 37209
Phone (615) 329-4401

324 22nd Ave N
Nashville, TN 37203
Phone (615) 329-4401

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": "1329609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1669745899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 22ND AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031842",
            "telephone_number": "615-329-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 22ND AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031842",
            "telephone_number": "615-329-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Cool Springs Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "TN",
            "postal_code": "370676475",
            "country_code": "US",
            "telephone_number": "615-778-0902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SYBO",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DDS,MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-19",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "11139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIAN",
            "last_name": "SYBO",
            "prefix": "DR.",
            "credential": "DDS,MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.