Bush Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

6240 Issued in AL

Legal business name

BUSH PEDIATRIC DENTISTRY

Practice address

4740 Woodmere Blvd
Montgomery, AL 36106-3065

Phone

(334) 676-2144

Fax

(334) 676-2148

NPI assigned

May 31, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Wayne Bush, DMDNPI 1285016527

Title

Dentist/Owner

Phone

(334) 504-0142

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Samuel Bush, D.M.D.

  • Dentist
  • Montgomery, AL
  • NPI 1285016527
  NPD (past) Authorized official

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496188800000",
    "number": "1578091815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 LANSDOWNE DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112115",
            "telephone_number": "334-504-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 WOODMERE BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063065",
            "telephone_number": "334-676-2144",
            "fax_number": "334-676-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUSH PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-31",
        "last_updated": "2017-05-31",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "334-504-0142",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "6240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Burntshirt LLC
• Adrianne Christine Burroughs, BEHAVIORAL ASSISTANT
• Dominique L Burroughs
• Sydney Grace Burt, OTR/L
• Hunter Neal Burton
• Julia Ashley Leonard Bush, M.S., CCC-SLP
• Phelicia Berry Bush, PHARM.D.
• Samuel Bush, D.M.D.
• Alexa Wilkinson Butler, PHARMD
• Paige Heath Butler, CRNP

• Pediatric Dentistry in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Pediatric Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2017; 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.