Teresa Bushnell

Primary specialty

Dental TherapistTaxonomy code 125J00000X

License

DT33 Issued in MN

Practice address

636 Broadway St NE
Minneapolis, MN 55413-2164

Phone

(612) 746-1530

NPI assigned

Jan 6, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Dental Services

  • Public Health Dentistry
  • Chisholm, MN
  • NPI 1669842662
  NPD (past)
• Childrens Dental Services Inc

  • Public Health Dentistry
  • Minneapolis, MN
  • NPI 1407973605
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1114315678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10845 E WEGENER RD",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557468231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 BROADWAY ST NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132164",
            "telephone_number": "612-746-1530"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Anne St NW",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566015113",
            "country_code": "US",
            "telephone_number": "218-444-9646 x1010",
            "fax_number": "218-444-9252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSHNELL",
        "first_name": "TERESA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "MN",
            "license": "DT33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Bernadette Bushaw, APN/CPNP
• Christine Lee Bushey, APRN
• Luke T Bushman, MPS, LPCC, LADC
• Theresa Bushman, PHD, RD, LD
• Trevor Cordel Bushman, DDS
• Carly Busker
• Marlene Grace Buskirk, RN
• Jessica Buss
• Katherine Abigail Buss
• Madeline C Busse Oneil, MSW, LICSW

• Dental Therapist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dental Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.