TIFFANY LYNNE BULLER, DDS — NPI 1891781894 (Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) in BELLBROOK, OH)

CMS-1500 Box 24J / 33a • NPI

1891781894

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

1223G0001X (CMS C5)

Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)

Box 32 Service Location & ZIP+4

4403 STATE ROUTE 725, SUITE C, BELLBROOK, OH, 45305

Official NPPES Practice Location

Practice Phone & Referral Fax

(937) 848-8662

Fax: (937) 848-2317

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1891781894 (TIFFANY LYNNE BULLER, DDS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1891781894` (NPI-1 Individual Practitioner)
Provider / Legal Name	TIFFANY LYNNE BULLER, DDS
Plain-English Specialty	Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) NUCC Code: `1223G0001X` (Dentist, General Practice)
Certifying / Licensing Body	American Dental Association (ADA) / State Board of Dental Examiners
Practice Location Address	4403 STATE ROUTE 725, SUITE C, BELLBROOK, OH, 45305
Practice Telephone / Fax	Tel: (937) 848-8662 \| Fax: (937) 848-2317
Administrative Mailing Address	4403 STATE ROUTE 725 STE C, BELLBROOK, OH, 45305-2700
Enumeration & Last Sync	Enumerated: 2005-09-25 \| CMS Record Updated: 2026-01-22

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

4403 STATE ROUTE 725, SUITE C, BELLBROOK, OH, 45305

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Plain-English Taxonomy & CMS Crosswalk (1223G0001X)

What Does Taxonomy Code 1223G0001X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1223G0001X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code C5 (Dentist)
Certifying / Accrediting Authority: American Dental Association (ADA) / State Board of Dental Examiners
Clinical Scope: Routine 6-month dental checkups, toothache, dental abscess, bleeding gums (periodontitis), or wisdom tooth extraction.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (TIFFANY LYNNE BULLER, DDS)

Typical CPT / Diagnostic Procedures:

Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions

Common Therapeutic Classes:

Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`122300000X` — Dentist Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: IN \| License: `12010111A` \| Primary: Secondary
`1223G0001X` — Dentist, General Practice Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: OH \| License: `30.022095` \| Primary: Yes (Primary)
`1223G0001X` — Dentist, General Practice Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)	State: KY \| License: `8558` \| Primary: Secondary

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TIFFANY LYNNE BULLER, DDS (NPI #1891781894)