Jeffrey M Burstein, D.D.S., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D9280 Issued in OR

Practice address

12750 SW 68TH Ave
Tigard, OR 97223-8596

Phone

(503) 620-6797

NPI assigned

Jun 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1114121720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12750 SW 68TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238596",
            "telephone_number": "503-620-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12750 SW 68TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238596",
            "telephone_number": "503-620-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURSTEIN",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D7213",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "48706",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "A94009",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D9280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Burnett, D.C.
• Lacey C Burnett
• Jeffrey M Burnham
• Grace Elaine Burns
• Terry Eugene Burris, M.D.
• Corey Daniel Burt, DC
• Mark Burton, PSY.D.
• Calanie Buss
• Deni R Buss, LMT
• Amanda Butler

• Oral and Maxillofacial Surgery (Dentist) in Tigard, OR
• Providers in Tigard, OR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.