Provider Demographics
NPI:1891781894
Name:BULLER-SCHUSSLER, TIFFANY LYNNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:LYNNE
Last Name:BULLER-SCHUSSLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TIFFANY L. BULLER-SCHUSSLER DDS LLC DBA BELLBROOK DENTA
Mailing Address - Street 2:4403 STATE ROUTE 725, SUITE C
Mailing Address - City:BELLBROOK
Mailing Address - State:OH
Mailing Address - Zip Code:45305
Mailing Address - Country:US
Mailing Address - Phone:937-848-8662
Mailing Address - Fax:937-848-2317
Practice Address - Street 1:4403 STATE ROUTE 725
Practice Address - Street 2:SUITE C
Practice Address - City:BELLBROOK
Practice Address - State:OH
Practice Address - Zip Code:45305
Practice Address - Country:US
Practice Address - Phone:937-848-8662
Practice Address - Fax:937-848-2317
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-25
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010111A122300000X
LA55411223G0001X
OH30-220951223G0001X
KY85581223G0001X
OH30.0220951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist