Douglas W Burgess DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

7404 Issued in MN

Legal business name

DOUGLAS W BURGESS DDS PA

Practice address

730 E Madison Ave
Mankato, MN 56001-6100

Phone

(507) 625-7550

Fax

(507) 388-3353

NPI assigned

Sep 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Wilford Burgess, DDS

Title

Owner

Phone

(507) 625-7550

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184726531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 E MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016100",
            "telephone_number": "507-625-7550",
            "fax_number": "507-388-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 E MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016100",
            "telephone_number": "507-625-7550",
            "fax_number": "507-388-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS W BURGESS DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "WILFORD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-625-7550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "7404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Donkin
• Tyler Maxwell Dority, PHD, LP
• Callah Hope Dornfeld
• Prabhjot Grace Dosanjh, M.D.
• Kaylee Dougall, M.S. CCC-SLP
• Faith Douglas
• Dovetail Traslation LLC
• Sarah Merfeld Downey, MS, ATC/R, CSCS
• Matthew R Downs, OD
• Cassandra Doyle

• Dentist in Mankato, MN
• Providers in Mankato, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.