Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bradly Robert Bush, DMD

Individual provider Dentist · NPI 1033219712

Bradly Robert Bush, DMD is a Dentist in Saint Louis, Missouri. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2006
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

1500 Park Ave
Saint Louis, MO 63104-3024
Phone: (314) 898-1700
Fax: (314) 814-8542
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019021954 (IL)

Record details

NPI number1033219712
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedSeptember 23, 2006
Last updated in NPPESSeptember 2, 2016
Mailing address1717 Biddle St, Saint Louis, MO 63106-3454

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