Brandon Bushong, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2012015439 Issued in MO

Practice address

2700 Martin Luther King Jr Blvd
Detroit, MI 48208-2576

Phone

(313) 494-6660

NPI assigned

Jul 9, 2012

Sex

Male

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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1336404078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082576",
            "telephone_number": "313-494-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 MARTIN LUTHER KING JR BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082576",
            "telephone_number": "313-494-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHONG",
        "first_name": "BRANDON",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2012015439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Lorenzo Bush, DO
• Ronald Darrell Bush II
• Vona Renee Bush
• Lashawnta Emma Bushell
• Randi Bushman, LMSW
• Hunia Bushra, B.D.S.
• Erin Elizabeth Busk-Sutton
• Belinda Busogi, MD
• Melanie Bussan, MD
• Charmane Antoinette Bussie, LLMSW

• Dentist in Detroit, MI
• Providers in Detroit, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.