Alesia Nicola Burge, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10304 Issued in CT

Practice address

2100 Dixwell Ave
Suite 64
Hamden, CT 06514-2406

Phone

(203) 288-3000

Fax

(203) 288-3004

NPI assigned

Sep 3, 2010

Last updated

Oct 25, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

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

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1003123605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 DIXWELL AVE",
            "address_2": "SUITE 64",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065142406",
            "telephone_number": "203-288-3000",
            "fax_number": "203-288-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DIXWELL AVE",
            "address_2": "SUITE 64",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065142406",
            "telephone_number": "203-288-3000",
            "fax_number": "203-288-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGE",
        "first_name": "ALESIA",
        "middle_name": "NICOLA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-03",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "10304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christina Burgess, BCBA, LBA-CT
• Alyssa Burns, LCSW
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• General Practice Dentistry in Hamden, CT
• Providers in Hamden, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.