Individual provider Active NPI

John Richard Burke, DDS

  • General Practice Dentistry
  • Spokane Valley, WA
National Provider Identifier
1265581979
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6275 Issued in WA
Practice address
1502 N Vercler Rd
Spokane Valley, WA 99216-1078
Phone
(509) 444-8888
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6275 WA Primary

Addresses

Primary practice location

1502 N Vercler Rd
Spokane Valley, WA 99216-1078

Mailing address

611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888

Other practice location 1

919 N Pines Rd
Spokane Valley, WA 99206-4932
Phone (509) 924-0381

Other identifiers 1

IdentifierTypeStateIssuer
5008123MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170829004288 WA Order and Referring Only - DentistPractitioner - Dentist 8527331313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6275WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Ryan a Bushman DMD & Chase D Davis DDS PLLC General Practice PastSince Sep 29, 2019 Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients
Community Health Association of Spokane Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: john.burke.1@11411.direct.athenahealth.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1265581979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888",
            "fax_number": "509-893-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 N VERCLER RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161078",
            "telephone_number": "509-444-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "919 N Pines Rd",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992064932",
            "country_code": "US",
            "telephone_number": "509-924-0381",
            "fax_number": "509-893-9485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURKE",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5008123",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.