Individual provider Active NPI

Ryan Bushman, DMD

  • Dentist
  • Spokane Valley, WA
National Provider Identifier
1851880934
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60855064 Issued in WA
Practice address
919 N Pines Rd
Spokane Valley, WA 99206
Phone
(509) 924-0381
NPI assigned
May 4, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60855064 WA Primary

Addresses

Primary practice location

919 N Pines Rd
Spokane Valley, WA 99206

Mailing address

919 N Pines Rd
Spokane Valley, WA 99206-4932
Phone (509) 924-0381

Other practice location 1

82 E Francis Ave
Spokane, WA 99208
Phone (509) 484-4746

Other identifiers 3

IdentifierTypeStateIssuer
153536142OtherAMERICAN DENTAL ASSOCIATION
2102572MedicaidWA
DE60855064OtherWAWA STATE DEPARTMENT OF HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE60855064WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan a Bushman DMD & Chase D Davis DDS PLLC CurrentSince Sep 29, 2019 Accepting new patients
Ryan Bushman DMD & Chase Davis DDS PLLC Dentist PastSince Apr 3, 2022 Accepting new patients
Hero Dental of Spokane PC Past Accepting new patients

Locations

919 N Pines Rd
Spokane Valley, WA 99206
Phone (509) 240-9339

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1851880934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 N PINES RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064932",
            "telephone_number": "509-924-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 N PINES RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "99206",
            "telephone_number": "509-924-0381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "82 E Francis Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "99208",
            "country_code": "US",
            "telephone_number": "509-484-4746",
            "fax_number": "509-484-8281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSHMAN",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-04",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60855064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN DENTAL ASSOCIATION",
            "identifier": "153536142",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2102572",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE DEPARTMENT OF HEALTH",
            "identifier": "DE60855064",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.