Individual provider Active NPI

Todd C. Burris, DMD

  • General Practice Dentistry
  • Shawnee, KS
National Provider Identifier
1174501530
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60148 Issued in KS
Practice address
7070 Renner Rd
Suite 202
Shawnee, KS 66217-3047
Phone
(913) 268-0888
Fax
(913) 268-3752
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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 60148 KS Primary

Addresses

Primary practice location

7070 Renner Rd
Suite 202
Shawnee, KS 66217-3047

Mailing address

7070 Renner Rd
Suite 202
Shawnee, KS 66217-3047
Phone (913) 268-0888

Other identifiers 2

IdentifierTypeStateIssuer
200175OtherKSBCBS OF KS PROVIDER NUMBE
32438028OtherKSBCBS OF KC PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
60148KSMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1174501530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7070 RENNER RD",
            "address_2": "SUITE 202",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662173047",
            "telephone_number": "913-268-0888",
            "fax_number": "913-268-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7070 RENNER RD",
            "address_2": "SUITE 202",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662173047",
            "telephone_number": "913-268-0888",
            "fax_number": "913-268-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRIS",
        "first_name": "TODD",
        "middle_name": "C.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KS PROVIDER NUMBE",
            "identifier": "200175",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KC PROVIDER #",
            "identifier": "32438028",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.