BUSH PEDIATRIC DENTISTRY NPI 1578091815

NPI Information

  • NPI: 1578091815
  • Provider Name: BUSH PEDIATRIC DENTISTRY
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • Address: 4740 WOODMERE BLVD
    MONTGOMERY, AL
    ZIP 36106
  • Phone: (334) 676-2144

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NPI Details

BUSH PEDIATRIC DENTISTRY is a pediatric dentistry dentist in Montgomery, AL. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. BUSH PEDIATRIC DENTISTRY NPI is 1578091815. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4740 WOODMERE BLVD
MONTGOMERY, AL
ZIP 36106-065
Phone: (334) 676-2144
Fax: (334) 676-2148

The provider's authorized official is Samuel Wayne Bush .
The authorized official title is Dentist/owner and has the following contact phone number (334) 504-0142.

The enumeration date for this NPI number is 5/31/2017 and was last updated on 5/31/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric Dentistry6240ALABAMAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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