Donald K. Burden, D.D.S.
Individual provider Active NPI Dentist · Waterloo, IL
NPI 1003856253 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1003856253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- Practice address
- 224 Bradford LN
Waterloo, IL 62298-3267 - Phone
- (618) 939-9599
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019-013956 | IL | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | IL | Yes |
Addresses
Primary practice location
224 Bradford LN
Waterloo, IL 62298-3267
Mailing address
224 Bradford LN
Waterloo, IL 62298-3267
Phone (618) 939-9599
Other providers in Waterloo, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.