Organization Active NPI

Smile Dental Spa and Wellness

  • Dentist
  • Virginia Beach, VA
National Provider Identifier
1164390894
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SMILE DENTAL SPA AND WELLNESS
Practice address
2020 S Independence Blvd Ste 3
Virginia Beach, VA 23453-4776
Phone
(757) 500-5591
Fax
(757) 500-5037
NPI assigned
Oct 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Authorized official

Name
Irama Lorena Bush, DDS
Title
Dentist
Phone
(757) 938-1744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2020 S Independence Blvd Ste 3
Virginia Beach, VA 23453-4776

Mailing address

2020 S Independence Blvd Ste 3
Virginia Beach, VA 23453-4776

National Provider Directory

National Provider Directory

Locations

2020 S Independence Blvd
Ste 3
Virginia Beach, VA 23453
Phone (757) 471-6977

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1761264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761264000000",
    "number": "1164390894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 S INDEPENDENCE BLVD STE 3",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234534776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 S INDEPENDENCE BLVD STE 3",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234534776",
            "telephone_number": "757-500-5591",
            "fax_number": "757-500-5037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DENTAL SPA AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-24",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "IRAMA",
        "authorized_official_middle_name": "LORENA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "757-938-1744",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.

Verify at the official NPI Registry.