Bradley Raymond Bendush, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12008546 Issued in IN

Practice address

115 N Shortridge Rd
Suite #200
Indianapolis, IN 46219-4908

Phone

(317) 353-1062

Fax

(317) 357-5999

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 15, 2015 through Oct 15, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293667200000",
    "number": "1962510610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N SHORTRIDGE RD",
            "address_2": "SUITE #200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194908",
            "telephone_number": "317-353-1062",
            "fax_number": "317-357-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N SHORTRIDGE RD",
            "address_2": "SUITE #200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194908",
            "telephone_number": "317-353-1062",
            "fax_number": "317-357-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDUSH",
        "first_name": "BRADLEY",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA",
            "identifier": "8546",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caley E Bender, FNP-C
• Jennifer Bender
• Paul M Bender
• Tiffany L L Bender
• Rani Bendersky, PHARMD
• John Francis Benecke, DO
• Mary Hart Benecke, OT
• Michelle Benedict-Bellamy
• Brittany Benedict, LAT, ATC
• Bryan Benedict, MD

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.