James Walter Bussiere, DMD

Individual provider Active NPI General Practice Dentistry · Hebron, CT

NPI 1841348554 · NPPES record last updated May 22, 2013

Key facts

NPI
1841348554
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
7753 (CT)
Practice address
20 Liberty Dr
Hebron, CT 06248
Phone
(860) 228-7878
Fax
(860) 228-4488
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

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 fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
007753CTMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Hebron Dentistry PC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 007753 CT
General Practice Dentistry 1223G0001X 7753 CT Yes

Addresses

Primary practice location

20 Liberty Dr
Hebron, CT 06248

Mailing address

PO Box 752
20 Liberty Dr
Hebron, CT 06248
Phone (860) 228-7878

Other providers in Hebron, CT

All providers in Hebron, CT · General Practice Dentistry in Connecticut

Sources for this page

Verify at the official NPI Registry.