Active NPI
Charles J Burliss, DMD,MSCD
- Periodontics
- Salem, NH
National Provider Identifier
1275628729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 2529
- Practice address
- 12 Stiles Rd
Suite 203
Salem, NH 03079 - Phone
- (603) 898-1961
- Fax
- (603) 898-4508
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 2529 | NH | Primary |
Addresses
Primary practice location
12 Stiles Rd
Suite 203
Salem, NH 03079
Mailing address
12 Stiles Rd
Suite 203
Salem, NH 03079
Phone (603) 898-1961
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2529 | NH | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charles J Burliss DMD MSCD PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Oral and Maxillofacial Surgery Clinic/Center
- Salem, NH
- NPI 1265647598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275628729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 STILES RD",
"address_2": "SUITE 203",
"city": "SALEM",
"state": "NH",
"postal_code": "03079",
"telephone_number": "603-898-1961",
"fax_number": "603-898-4508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 STILES RD",
"address_2": "SUITE 203",
"city": "SALEM",
"state": "NH",
"postal_code": "03079",
"telephone_number": "603-898-1961",
"fax_number": "603-898-4508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURLISS",
"first_name": "CHARLES",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DMD,MSCD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NH",
"license": "2529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.