Neeta F Bhushan, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

019027625 Issued in IL

Practice address

136 S Bolingbrook Dr
Bolingbrook, IL 60440-2852

Phone

(630) 739-5500

Fax

(630) 739-5505

NPI assigned

Jul 17, 2008

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 17, 2008.

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1083878151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 N SHERIDAN RD",
            "address_2": "UNIT 26A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606603818",
            "telephone_number": "773-562-7868",
            "fax_number": "630-739-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S BOLINGBROOK DR",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402852",
            "telephone_number": "630-739-5500",
            "fax_number": "630-739-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHUSHAN",
        "first_name": "NEETA",
        "middle_name": "F",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "019027625",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.