Provider Demographics
NPI:1669745899
Name:SYBO, BRIAN (DDS,MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:SYBO
Suffix:
Gender:M
Credentials:DDS,MD
Other - Prefix:DR
Other - First Name:BRIAN
Other - Middle Name:
Other - Last Name:SYBO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS,MD
Mailing Address - Street 1:324 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1842
Mailing Address - Country:US
Mailing Address - Phone:615-329-4401
Mailing Address - Fax:
Practice Address - Street 1:324 22ND AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1842
Practice Address - Country:US
Practice Address - Phone:615-329-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-19
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN111391223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty