Dominique Burdette

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

STUDENT Issued in OK

Practice address

301 S J T Stites St
Sallisaw, OK 74955-9302

Phone

(918) 775-9150

NPI assigned

May 5, 2020

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 5, 2020.

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1003437757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3863 W 173RD ST N",
            "city": "SKIATOOK",
            "state": "OK",
            "postal_code": "740709404",
            "telephone_number": "918-637-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S J T STITES ST",
            "city": "SALLISAW",
            "state": "OK",
            "postal_code": "749559302",
            "telephone_number": "918-775-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDETTE",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OK",
            "license": "STUDENT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Broussard, M.S., LPC
• Amy Marie Brown, APRN-CNP
• Shelly Brown
• Brushy Elementary School
• Samantha Ronae Bumguardner, YOUTH SERVICE
• Doris E Burmaster, MANAGEMENT
• Christopher Alan Bush, RN
• Bwdentistry
• Darlene Cantu
• Timothy Aaron Cardenaz, PHARM.D.

• All providers in Sallisaw, OK
• Dental Hygienist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.