Active NPI
Jack C Bushman, DMD
- General Practice Dentistry
- Auburn, AL
National Provider Identifier
1033464938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5931
- Practice address
- 2234 Ogletree Village LN
Auburn, AL 36830-2967 - Phone
- (334) 539-5570
- NPI assigned
- Jul 17, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5931 | AL | Primary |
Addresses
Primary practice location
2234 Ogletree Village LN
Auburn, AL 36830-2967
Mailing address
3346 Stratford LN
Montgomery, AL 36111-1732
Phone (334) 799-8701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5931 | AL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753401600000",
"number": "1033464938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3346 STRATFORD LN",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361111732",
"telephone_number": "334-799-8701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2234 OGLETREE VILLAGE LN",
"city": "AUBURN",
"state": "AL",
"postal_code": "368302967",
"telephone_number": "334-539-5570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSHMAN",
"first_name": "JACK",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-17",
"last_updated": "2025-07-25",
"certification_date": "2025-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "5931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.