Ivo Bushati, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN 20607 Issued in FL

Practice address

5299 Park Blvd N
Pinellas Park, FL 33781-3418

Phone

(727) 686-1808

NPI assigned

May 29, 2014

Last updated

Sep 20, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bay Area Modern Dentistry LLC

  • Dentist
  • Pinellas Park, FL
  • NPI 1134702111
  NPD Authorized official

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1952713547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5299 PARK BLVD N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813418",
            "telephone_number": "727-547-8227",
            "fax_number": "727-547-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5299 PARK BLVD N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813418",
            "telephone_number": "727-686-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSHATI",
        "first_name": "IVO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-29",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 20607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012230100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Burgos
• Autumn Burns, DC
• Joshua Richard Burns, DDS
• Krista Burns, DC
• Brittany Mei Burroughs, DNP
• Eilyn Gabriela Bustamante
• Jessica Butler, MSW
• Wendy Joann Butler
• Ernest D Buzzella Jr., DC
• Arianne Marie Byers, APRN

• Dentist in Pinellas Park, FL
• Providers in Pinellas Park, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.