Individual provider Active NPI

Jonathan S Burke, D. D. S.

  • General Practice Dentistry
  • Crown Point, IN
National Provider Identifier
1124066311
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12009850 Issued in IN
Practice address
1410 E Joliet St
Suite D
Crown Point, IN 46307-4724
Phone
(219) 662-9932
Fax
(219) 663-9688
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 12009850 IN Primary

Addresses

Primary practice location

1410 E Joliet St
Suite D
Crown Point, IN 46307-4724

Mailing address

1410 E Joliet St
Suite D
Crown Point, IN 46307-4724
Phone (219) 662-9932

Other identifiers 1

IdentifierTypeStateIssuer
12009850OtherINLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150506002456 IN Order and Referring Only - DentistPractitioner - Dentist 5092985994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12009850INMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan S. Burke, DDS, PC PastSince Jul 15, 2011 Accepting new patients
Kevin M Brunski DDS PC General Practice Past Accepting new patients

Organizations & group practices 2

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124066311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 E JOLIET ST",
            "address_2": "SUITE D",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463074724",
            "telephone_number": "219-662-9932",
            "fax_number": "219-663-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 E JOLIET ST",
            "address_2": "SUITE D",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463074724",
            "telephone_number": "219-662-9932",
            "fax_number": "219-663-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "JONATHAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D. D. S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "12009850",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.