Healthcare Provider Details

I. General information

NPI: 1255034799
Provider Name (Legal Business Name): TORI BUSSANMAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E NICOLLET BLVD STE 200
BURNSVILLE MN
55337-6785
US

IV. Provider business mailing address

6600 FRANCE AVE S STE 315
EDINA MN
55435-1803
US

V. Phone/Fax

Practice location:
  • Phone: 952-278-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number82599
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: