Tad Wylie Burzynski, L.D., R.D.H.

Primary specialty

DenturistTaxonomy code 122400000X

License

DT-DO 557317 Issued in OR

Practice address

853 NE 4TH St
Bend, OR 97701-4709

Phone

(541) 389-7485

Fax

(541) 322-0557

NPI assigned

May 24, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Denture in

  • Denturist
  • Bend, OR
  • NPI 1013871433
  NPD Authorized official

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083825962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 NE 4TH ST.",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-389-7485",
            "fax_number": "541-322-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 NE 4TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014709",
            "telephone_number": "541-389-7485",
            "fax_number": "541-322-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURZYNSKI",
        "first_name": "TAD",
        "middle_name": "WYLIE",
        "name_prefix": "Mr.",
        "credential": "L.D., R.D.H.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "OR",
            "license": "DT-DO 557317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelanna Rae Burton
• William Young Burton, M.D.
• Robin Burwell, LCSW
• Jennifer Bury, LAC
• Andrew Kyle Burzynski, LD
• Tanner Busacker, NRP
• Dean Joseph Busby, MD
• Tina Marie Busby, MD
• Samuel Busche, PHARMD
• Hunter Buschke, BS

• Denturist in Bend, OR
• Providers in Bend, OR by specialty
• Denturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.