NPIMap

Organization Active NPI

J.Dieter Burr, DMD PA

  • Dental Clinic/Center
  • Cocoa, FL
National Provider Identifier
1225309602
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN19285 Issued in FL
Legal business name
J.DIETER BURR, DMD PA
Practice address
6825 N Highway 1
Cocoa, FL 32927-5012
Phone
(321) 631-2111
NPI assigned
Jan 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Authorized official

Name
Dr. Juckapong Dieter Burr, DMD
Title
Member
Phone
(352) 223-5459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DN19285 FL Primary

Addresses

Primary practice location

6825 N Highway 1
Cocoa, FL 32927-5012

Mailing address

6825 N Highway 1
Cocoa, FL 32927-5012
Phone (321) 631-2111

National Provider Directory

National Provider Directory

Locations

6825 N Highway 1
Port Saint John, FL 32927
Phone (321) 631-2111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1225309602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6825 N HIGHWAY 1",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329275012",
            "telephone_number": "321-631-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6825 N HIGHWAY 1",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329275012",
            "telephone_number": "321-631-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J.DIETER BURR, DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "BURR",
        "authorized_official_first_name": "JUCKAPONG",
        "authorized_official_middle_name": "DIETER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "352-223-5459",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN19285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.