Active NPI
Brandon James Burke, D.D.S.
- Dentist
- Libby, MT
National Provider Identifier
1174804314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2477
- Practice address
- 320 E 2ND St
Libby, MT 59923-2010 - Phone
- (406) 293-3755
- NPI assigned
- Sep 1, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2477 | MT | Primary |
Addresses
Primary practice location
320 E 2ND St
Libby, MT 59923-2010
Mailing address
320 E 2ND St
Libby, MT 59923-2010
Phone (919) 623-4888
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2477 | MT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358380800000",
"number": "1174804314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 E 2ND ST",
"city": "LIBBY",
"state": "MT",
"postal_code": "599232010",
"telephone_number": "919-623-4888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 E 2ND ST",
"city": "LIBBY",
"state": "MT",
"postal_code": "599232010",
"telephone_number": "406-293-3755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKE",
"first_name": "BRANDON",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-01",
"last_updated": "2013-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MT",
"license": "2477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Libby, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.