NPIMap

Organization Active NPI

Ultra Orthodontics

Doing business as Burson Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Longview, TX
National Provider Identifier
1114234556
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
9121 Issued in TX
Legal business name
ULTRA ORTHODONTICS
Doing business as
Burson Orthodontics
Practice address
3006 H G Mosley Pkwy
Longview, TX 75605-2948
Phone
(903) 753-2151
Fax
(903) 753-0884
NPI assigned
Sep 7, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Dr. Patrick Briscoe, DDS, MSNPI 1063533354
Title
Owner/Doctor
Phone
(903) 261-4711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 9121 TX Primary

Addresses

Primary practice location

3006 H G Mosley Pkwy
Longview, TX 75605-2948

Mailing address

627 Turtle Creek Dr
Tyler, TX 75701-1832
Phone (903) 597-6372

Other names 1

  • Burson Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

3006 H G Mosley Pkwy
Longview, TX 75605
Phone (903) 753-2151

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1114234556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 TURTLE CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011832",
            "telephone_number": "903-597-6372",
            "fax_number": "903-592-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3006 H G MOSLEY PKWY",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052948",
            "telephone_number": "903-753-2151",
            "fax_number": "903-753-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRA ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-07",
        "last_updated": "2023-09-06",
        "certification_date": "2020-08-10",
        "status": "A",
        "authorized_official_last_name": "BRISCOE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "903-261-4711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "9121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burson Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.