Taylor Bushman
Individual provider Active NPI General Practice Dentistry · Ottawa, IL
NPI 1740113562 · NPPES record last updated Jun 3, 2026
Key facts
- NPI
- 1740113562
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 019.037132 (IL)
- Practice address
- 1300 Starfire Dr
Ottawa, IL 61350-1624 - Phone
- (815) 433-3413
- NPI assigned
- Jun 3, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.037132 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019.037132 | IL | Yes |
Addresses
Primary practice location
1300 Starfire Dr
Ottawa, IL 61350-1624
Mailing address
2738 E 2625TH Rd
Marseilles, IL 61341-9484
Phone (815) 830-3344
Other providers in Ottawa, IL
- Brittany M Jones DPM LLC
- Yulandist Jeannie Brown
- Carol Ruth Buckner
- Doris Burke
- Gail Marie Burke
- Alison Bute
- Byron L. Perry DC PC Inc
- Cynthia Asuncion Cabalfin
- Calhoun Consultants LLC
- Lacey Marie Carls
All providers in Ottawa, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.