Bushong Dental, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BUSHONG DENTAL, PLLC

Doing business as

Dominion Dental
Dominion Dental Spa

Practice address

4 Dominion Dr # 250
San Antonio, TX 78257-1390

Phone

(210) 687-1150

NPI assigned

Dec 11, 2020

Last updated

Dec 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Perry J Bushong II, DDSNPI 1992069728

Title

President

Phone

(817) 851-3291

Specialties & licenses 1

Addresses

Other names 2

• Dominion Dental Doing business as
• Dominion Dental Spa Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Perry Joseph Bushong II, D.D.S.

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1992069728
  NPD Authorized official

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1750977914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14806 CIRCLE J TRL",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780233829",
            "telephone_number": "817-851-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 DOMINION DR # 250",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571390",
            "telephone_number": "210-687-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUSHONG DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "BUSHONG",
        "authorized_official_first_name": "PERRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-851-3291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dominion Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dominion Dental Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie Ann Bush, M.S., CCC-SLP
• Melanie Marie Bush, LCDC-I
• Henry Bushey, MD
• Kristin Nicole Bushman
• Judith Bushnell, LPC
• Alexi Brook Bushong
• Armita Anari Bushong, D.D.S
• Perry Joseph Bushong II, D.D.S.
• Sara Marie Bushur, WHNP-BC
• Kristin L Bussey-Smith, MD

• Dental Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.