Individual provider Active NPI

Brea A Bush, RDH

  • Dental Hygienist
  • Erie, PA
National Provider Identifier
1881922656
Registry record updated Dec 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH070115 Issued in PA
Practice address
1720 Holland St
Erie, PA 16503-1808
Phone
(814) 456-8548
Fax
(814) 456-2375
NPI assigned
Dec 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH070115 PA Primary

Addresses

Primary practice location

1720 Holland St
Erie, PA 16503-1808

Mailing address

PO Box 369
Erie, PA 16512-0369
Phone (814) 454-4530

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
DH070115PAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1260057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260057600000",
    "number": "1881922656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165120369",
            "telephone_number": "814-454-4530",
            "fax_number": "814-456-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 HOLLAND ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165031808",
            "telephone_number": "814-456-8548",
            "fax_number": "814-456-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "BREA",
        "middle_name": "A",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-06",
        "last_updated": "2009-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "PA",
            "license": "DH070115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2009; 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.