NPIMap

Organization Active NPI

3-D Imaging of Southern Illinois, Inc.

  • Dental Clinic/Center
  • Belleville, IL
National Provider Identifier
1124280706
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
19-13956 Issued in IL
Legal business name
3-D IMAGING OF SOUTHERN ILLINOIS, INC.
Practice address
5899 N Belt W
Suite B
Belleville, IL 62226-4617
Phone
(618) 222-1722
NPI assigned
Jun 25, 2008
Last updated
Jun 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
Dr. Donald K Burden, D.D.S.
Title
President
Phone
(618) 222-1722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 19-13956 IL Primary

Addresses

Primary practice location

5899 N Belt W
Suite B
Belleville, IL 62226-4617

Mailing address

5899 N Belt W
Suite B
Belleville, IL 62226-4617
Phone (618) 222-1722

National Provider Directory

National Provider Directory

Locations

5899 N Belt W
Ste B
Belleville, IL 62226
Phone (618) 222-1722

NPI Registry JSON

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1124280706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5899 N BELT W",
            "address_2": "SUITE B",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622264617",
            "telephone_number": "618-222-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5899 N BELT W",
            "address_2": "SUITE B",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622264617",
            "telephone_number": "618-222-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3-D IMAGING OF SOUTHERN ILLINOIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "BURDEN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-222-1722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "19-13956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.