Individual provider Active NPI

Alexander Burns, DDS

  • General Practice Dentistry
  • Lakewood, CA
National Provider Identifier
1043399843
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28663 Issued in CA
Practice address
4128 Paramont Blvd
Lakewood, CA 90712-3914
Phone
(562) 425-6463
Fax
(562) 427-4044
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 28663 CA Primary

Addresses

Primary practice location

4128 Paramont Blvd
Lakewood, CA 90712-3914

Mailing address

4128 Paramont Blvd
Lakewood, CA 90712-3914
Phone (562) 425-6463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20160211002632 CA Order and Referring Only - DentistPractitioner - Dentist 0648574640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28663CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1043399843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 PARAMONT BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907123914",
            "telephone_number": "562-425-6463",
            "fax_number": "562-427-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4128 PARAMONT BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907123914",
            "telephone_number": "562-425-6463",
            "fax_number": "562-427-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

Verify at the official NPI Registry.