Active NPI
John Bradley Burleson, D.D.S.
- General Practice Dentistry
- Cabot, AR
National Provider Identifier
1174537609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2022033495
- Practice address
- 3284 Highway 367 S
Cabot, AR 72023-7444 - Phone
- (501) 843-5808
- Fax
- (501) 941-3572
- NPI assigned
- Jul 28, 2006
- Last updated
- Feb 8, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3476 | AR | |
| General Practice Dentistry | 1223G0001X | 7652 | OK | |
| General Practice Dentistry | 1223G0001X | 2022033495 | MO | Primary |
Addresses
Primary practice location
3284 Highway 367 S
Cabot, AR 72023-7444
Mailing address
3284 Highway 367 S
Cabot, AR 72023-7444
Phone (501) 843-5808
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022033495 | MO | MD | General Practice Dentistry |
| 7652 | OK | MD | General Practice Dentistry |
| 3476 | AR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sharp Family Dentistry, PLLC | Past | Accepting new patients | |
| Burleson Family Dentistry | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Cabot, AR
- NPI 1578651691
-
- Dental Clinic/Center
- Cabot, AR
- NPI 1518475508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1174537609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3284 HIGHWAY 367 S",
"city": "CABOT",
"state": "AR",
"postal_code": "720237444",
"telephone_number": "501-843-5808",
"fax_number": "501-941-3572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3284 HIGHWAY 367 S",
"city": "CABOT",
"state": "AR",
"postal_code": "720237444",
"telephone_number": "501-843-5808",
"fax_number": "501-941-3572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURLESON",
"first_name": "JOHN",
"middle_name": "BRADLEY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "3476",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "7652",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2022033495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cabot, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.