Alan Jeffrey Burge, DDS
Individual provider Active NPI General Practice Dentistry · Pekin, IL
NPI 1184649485 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1184649485
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 1915532 (IL)
- Practice address
- 3218 Court St
Pekin, IL 61554-6209 - Phone
- (309) 347-8590
- Fax
- (309) 347-8612
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1915532 | IL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alan Burge DDS | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1915532 | IL | Yes |
Addresses
Primary practice location
3218 Court St
Pekin, IL 61554-6209
Mailing address
3218 Court St
Pekin, IL 61554-6209
Phone (309) 347-8590
Other providers in Pekin, IL
- Emily Irene Brown
- Kara Kathleen Brown
- Chelsea L Brush
- James Arthur Budds
- Lisa Marie Buettner
- Emily Burrows
- Bernie Allen Butler
- Joashly Calingacion
- Danny Roscoe Callahan
- Nels Calvert
All providers in Pekin, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.