Individual provider Active NPI

Alicia Grambeau Burton, DDS

  • Dentist
  • Medical Lake, WA
National Provider Identifier
1104171214
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D4443 Issued in ID
Practice address
47 E Highway 902
Medical Lake, WA 99022-5127
Phone
(509) 260-2650
NPI assigned
Jul 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D4443 ID Primary

Addresses

Primary practice location

47 E Highway 902
Medical Lake, WA 99022-5127

Mailing address

47 E Highway 902
Medical Lake, WA 99022-5127
Phone (509) 260-2650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160504001476 WA Order and Referring Only - DentistPractitioner - Dentist 9032418579

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D4443IDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alicia Burton DDS PLLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1104171214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 E HIGHWAY 902",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990225127",
            "telephone_number": "509-260-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 E HIGHWAY 902",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990225127",
            "telephone_number": "509-260-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON",
        "first_name": "ALICIA",
        "middle_name": "GRAMBEAU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-16",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medical Lake, WA

Sources for this page

Verify at the official NPI Registry.