Individual provider Active NPI

Bushra M Omar, DDS

  • General Practice Dentistry
  • Firestone, CO
National Provider Identifier
1609446616
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN.00204991 Issued in CO
Practice address
4275 City Centre Dr Unit 400
Firestone, CO 80504-6678
Phone
(720) 845-6636
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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 DEN.00204991 CO Primary

Addresses

Primary practice location

4275 City Centre Dr Unit 400
Firestone, CO 80504-6678

Mailing address

4275 City Centre Dr Unit Ste400
Firestone, CO 80504-6674
Phone (720) 845-6636

Other practice location 1

660 Bannock St # L
Denver, CO 80204-4506
Phone (303) 602-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20250219003284 CO Practitioner - Dentist 8426578535 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00204991COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Dec 19, 2024 Accepting new patients
Denver Health and Hospital Authority CurrentSince Dec 19, 2024 Accepting new patients
Unmc College of Dentistry PastSince Jul 1, 2021 Accepting new patients

Locations

777 Bannock St
#1923
Denver, CO 80204
Phone (303) 602-2720

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: bomar301028@direct.dhha.org

Organizations & group practices 3

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": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1609446616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4275 CITY CENTRE DR UNIT STE400",
            "city": "FIRESTONE",
            "state": "CO",
            "postal_code": "805046674",
            "telephone_number": "720-845-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 CITY CENTRE DR UNIT 400",
            "city": "FIRESTONE",
            "state": "CO",
            "postal_code": "805046678",
            "telephone_number": "720-845-6636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 Bannock St # L",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802044506",
            "country_code": "US",
            "telephone_number": "303-602-8200",
            "fax_number": "303-602-4560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OMAR",
        "first_name": "BUSHRA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00204991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Firestone, CO

Sources for this page

Verify at the official NPI Registry.