DR. ROBERT JOHN BUSCH (NPI# 1467669762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467669762 |
| Entity Type | Individual |
| Full Name | DR. ROBERT JOHN BUSCH |
| Credential | DMD MD |
| Practice Address |
2807 N Knoxville Ave Peoria IL 61604-2869 |
| Practice Telephone | 3096821213 |
| Practice Fax Number | 3096821213 |
| Mailing Telephone | 3096821213 |
| Mailing Fax Number | 3096821213 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2015-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
0021934 | TX | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | BP10028831 | TX | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | PHYSICIAN IN TRAINING | BP10028831 | 01 |
| TX | 177585009 | 05 | |
| TX | TX DENTAL | 21934 | 01 |
| TX | 177585010 | 05 | |
| TX | BLUE CROSS BLUE SHIELD | 1467669762 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932380193 | Robert Sisson Busch | Technician/Technologist | 1726 E Southern Ave, Suite 6, Tempe, AZ 85282-5686 | 2007-11-16 |
| 1770117087 | Robert Busch | Hearing Instrument Specialist | 3425 Simpson Ferry Rd Ste 202, Camp Hill, PA 17011-6405 | 2020-02-25 |
| 1801374566 | Robert Peter Busch | Physician Assistant | 1555 Long Pond Rd, Rochester, NY 14626-4122 | 2018-08-03 |
| 1326569641 | Robert Allen Busch | Pharmacist | 100 S Carol Malone Blvd, Grayson, KY 41143-1352 | 2017-06-28 |
| 1124381348 | Robert Franklin Busch | Psychiatry & Neurology | 100 Emancipation Dr, Hampton, VA 23667 | 2012-06-21 |
| 1982848685 | Robert Busch | Internal Medicine | 55 Fruit St, Massachusetts General Hospital Bul-148, Boston, MA 02114-2621 | 2009-04-24 |
| 1063466811 | Robert George Busch | Urology | 4601 W Us Highway 90, Lake City, FL 32055-4880 | 2006-05-19 |
| 1457358715 | Robert Steven Busch | Internal Medicine | 1365 Washington Ave, Ste 300, Albany, NY 12206-1098 | 2005-07-01 |
| Street Address |
2807 N KNOXVILLE AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61604-2869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154357291 | Associated Oral and Maxillofacial Surgeons of Peoria, Ltd | Dentist | 2807 N Knoxville Ave, Peoria, IL 61604-2869 | 2006-06-23 |
| 1356558282 | Nathan D Schroeder | Dentist | 2807 N Knoxville Ave, Peoria, IL 61604-2869 | 2007-05-17 |
| 1194859355 | Larry D Otte | Dentist | 2807 N Knoxville Ave, Peoria, IL 61604-2869 | 2007-03-16 |
| 1003915075 | Nadeem S Esmail | Dentist | 2807 N Knoxville Ave, Peoria, IL 61604-2869 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205357928 | Nydia I Rodriguez | Nurse's Aide | 3305 N Finnell Ave, Peoria, IL 61604 | 2017-07-03 |
| 1720327976 | Brin Diagnostics Inc. | Clinical Medical Laboratory | 3216 W Kenwood, West Peoria, IL 61604 | 2013-02-07 |
| 1225373715 | Ngocyen Thi Ngo | Pharmacist | 2515 N Knoxville Avenue, Peoria, IL 61604 | 2012-12-10 |
| 1194027003 | Schelly Chiropractic, Inc | Chiropractor | 1208 W Loucks, Peoria, IL 61604 | 2010-11-29 |
| 1770755852 | Dental Sealants & More | Dentist | 2126 N. University St., Peoria, IL 61604 | 2008-03-28 |
| 1821266123 | David L Krick | Dentist | 2022 N University, Peoria, IL 61604 | 2008-02-20 |
| 1568658409 | Advanced Physicians Health Care, S.c. | Chiropractor | 1200 West Loucks Ave, Peoria, IL 61604 | 2007-09-24 |
| 1902006000 | Noel Liu | Dentist | 3127 N. University St., Unit C, Peoria, IL 61604 | 2007-07-18 |
| 1568586386 | Susan B Bordenave-bishop | Dentist | 2116 N. Sheridan, Peoria, IL 61604 | 2007-03-19 |
| 1174689897 | Paul Anthony Amodeo | Dentist | 3100 N Dries Lane, Suite 301, Peoria, IL 61604 | 2006-12-28 |
| Find all providers in zip 61604 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154357291 | Associated Oral and Maxillofacial Surgeons of Peoria, Ltd | Dentist | 2807 N Knoxville Ave, Peoria, IL 61604-2869 | 2006-06-23 |
| 1134194996 | Stuart S. Sanders | Dentist | 10613 W Olive Ave, Suite 201, Peoria, AZ 85345-7339 | 2006-02-22 |
| 1356558282 | Nathan D Schroeder | Dentist | 2807 N Knoxville Ave, Peoria, IL 61604-2869 | 2007-05-17 |
| 1609914209 | James B Edwards | Dentist | 15188 N 75th Ave, Peoria, AZ 85381-4723 | 2007-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255986576 | Othman Rezki | Dentist | 1900 W Polk St # 611, Chicago, IL 60612-3723 | 2019-08-04 |
| 1215410584 | David Peterson | Dentist | 1619 Brandywine Ln, Dixon, IL 61021-8757 | 2018-09-12 |
| 1952887374 | Winnebago Braces, LLC. | Dentist | 555 N Court St Ste 110, Rockford, IL 61103-6898 | 2018-07-18 |
| 1093232951 | Robert C. Bosack, Dds & Associates, Ltd | Dentist | 16011 108th Ave Ste A, Orland Park, IL 60467-8787 | 2017-08-23 |
| 1790146132 | Family Millennium Dentistry, Inc. | Dentist | 1342 W Randolph St, Chicago, IL 60607-1522 | 2016-03-13 |
| 1770962375 | Eunsu Jung | Dentist | 1902 N Prospect Ave Ste 1, Champaign, IL 61822-1411 | 2015-05-28 |
| 1811374945 | Alexandria Hawkins | Dentist | 6050 Brynwood Dr Ste 102, Rockford, IL 61114-6579 | 2015-04-27 |
| 1043607872 | Alissa Nicole Pullos | Dentist | 105 E 1st St Ste 103, Hinsdale, IL 60521 | 2015-04-20 |
| 1538592654 | Matthew Seena Hamedani | Dentist | 3116 Oak Park Ave, Berwyn, IL 60402 | 2013-08-13 |
| 1578907689 | M Timothy Murphy | Dentist | 500 Davis St Ste 509, Evanston, IL 60201-4621 | 2013-04-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.