Individual provider Active NPI

Irama Lorena Bush, DDS

  • General Practice Dentistry
  • Virginia Beach, VA
National Provider Identifier
1457687089
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401412668 Issued in VA
Practice address
2020 S Independence Blvd Ste 3
Virginia Beach, VA 23453-4776
Phone
(757) 500-5591
NPI assigned
Nov 2, 2009
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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 0401412668 VA 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
Phone (757) 500-5591

Other names 1

  • Lorena Bush Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20160505001161 VA Order and Referring Only - DentistPractitioner - Dentist 3678872082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401412668VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Dental Spa and Wellness Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1457687089",
    "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",
            "telephone_number": "757-500-5591",
            "fax_number": "757-500-5037"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "IRAMA",
        "middle_name": "LORENA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401412668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORENA",
            "last_name": "BUSH",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.