Amanda Bridges Burke, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

3661-12 Issued in MS

Practice address

22 Eastgate Dr
Brandon, MS 39042-2318

Phone

(601) 825-1105

NPI assigned

Jun 25, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Burke Dental Group

  • Dental Clinic/Center
  • Brandon, MS
  • NPI 1134882822
  NPD Authorized official
• Mayatte Family Dentistry, LLC

  • General Practice Dentistry
  • Brandon, MS
  • NPI 1316154776
  NPD (past)

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1265796262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 EASTGATE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422318",
            "telephone_number": "601-825-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 EASTGATE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422318",
            "telephone_number": "601-825-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "AMANDA",
        "middle_name": "BRIDGES",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3661-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chesley Kelly Bullin
• Brittany Chantriece Burage, FNP-C
• Rachel Burchfield
• Braylen Kennedy Burdine
• Burke Dental Group
• Lekita Shunya Burks
• Penelope G Burns
• Nancy Burrow, M.D.
• Kasondra Jo Burt, LPN
• Susan M Burton, DMD

• Dentist in Brandon, MS
• Providers in Brandon, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.