Individual provider Active NPI

Thomas C Burm Jr., DMD

  • Pediatric Dentistry
  • Rochester, NY
National Provider Identifier
1174638183
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0479561 Issued in NY
Practice address
523 Beahan Rd
Rochester, NY 14624-3403
Phone
(585) 426-2550
Fax
(585) 426-4118
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0479561 NY Primary

Addresses

Primary practice location

523 Beahan Rd
Rochester, NY 14624-3403

Mailing address

523 Beahan Rd
Rochester, NY 14624-3403
Phone (585) 426-2550

Other identifiers 1

IdentifierTypeStateIssuer
01975011MedicaidNY

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
0479561NYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cynthia K Slack DDS PC Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1174638183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 BEAHAN RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146243403",
            "telephone_number": "585-426-2550",
            "fax_number": "585-426-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 BEAHAN RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146243403",
            "telephone_number": "585-426-2550",
            "fax_number": "585-426-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURM",
        "first_name": "THOMAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "0479561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01975011",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; 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.