Individual provider Active NPI

Jose Antonio Bushdid, D.M.D.

  • General Practice Dentistry
  • Coral Gables, FL
National Provider Identifier
1295934586
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN15001 Issued in FL
Practice address
3005 Salzedo St
Coral Gables, FL 33134-6711
Phone
(305) 444-5926
Fax
(305) 444-7724
NPI assigned
Jul 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN15001 FL Primary

Addresses

Primary practice location

3005 Salzedo St
Coral Gables, FL 33134-6711

Mailing address

3005 Salzedo St
Coral Gables, FL 33134-6711
Phone (305) 444-5926

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

LicenseStateTypeSpecialty
DN15001FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1295934586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 SALZEDO ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331346711",
            "telephone_number": "305-444-5926",
            "fax_number": "305-444-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 SALZEDO ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331346711",
            "telephone_number": "305-444-5926",
            "fax_number": "305-444-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHDID",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.