Burris-Dake Oral Surgery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3802 Issued in AR

Legal business name

BURRIS-DAKE ORAL SURGERY

Practice address

2801 S Olive St
Suite 33B
Pine Bluff, AR 71603-5433

Phone

(870) 534-2131

Fax

(870) 534-2175

NPI assigned

Dec 14, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin G Burris, DDS

Title

Sole Manager

Phone

(870) 534-2131

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1255634291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 S OLIVE ST",
            "address_2": "SUITE 33B",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716035433",
            "telephone_number": "870-534-2131",
            "fax_number": "870-534-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 S OLIVE ST",
            "address_2": "SUITE 33B",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716035433",
            "telephone_number": "870-534-2131",
            "fax_number": "870-534-2175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURRIS-DAKE ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "BURRIS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SOLE MANAGER",
        "authorized_official_telephone_number": "870-534-2131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AR",
            "license": "3802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia D Bullard, LPC
• Troy Joseph Bunger
• Roslyn Denise Burks, APN
• Bonny Burnett, SLP
• Roy Louis Burrell, MD
• Sheena K Burton, BS, MHPP
• Brittany Butterfield, PHARMD
• Oberia Lashon Byrd-Hunt
• David Larry Byrd, PD
• Jaron Fredrick Byrd, MD

• Oral and Maxillofacial Surgery (Dentist) in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.