NPIMap

Organization Active NPI

Ryan Bushman DMD & Chase Davis DDS PLLC

  • Dentist
  • Medical Lake, WA
National Provider Identifier
1679213375
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RYAN BUSHMAN DMD & CHASE DAVIS DDS PLLC
Practice address
123 N Brower St
Medical Lake, WA 99022-5109
Phone
(509) 299-5171
NPI assigned
Mar 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Ashlie Riverson
Title
Billing Credentialing Manager
Phone
(509) 924-0381

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

123 N Brower St
Medical Lake, WA 99022-5109

Mailing address

1222 N Pines Rd Ste 101
Spokane Valley, WA 99206-4939
Phone (509) 924-0381

Other names 1

  • Medical Lake Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1222 N Pines Rd
Ste 101
Spokane Valley, WA 99206
Phone (509) 924-0381

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1679213375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 N PINES RD STE 101",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064939",
            "telephone_number": "509-924-0381",
            "fax_number": "509-893-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N BROWER ST",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990225109",
            "telephone_number": "509-299-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN BUSHMAN DMD & CHASE DAVIS DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "RIVERSON",
        "authorized_official_first_name": "ASHLIE",
        "authorized_official_title_or_position": "BILLING CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "509-924-0381"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Lake Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medical Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.