Individual provider Active NPI

Brittany Anne Burgess, D.M.D.

  • Dentist
  • Tuscumbia, AL
National Provider Identifier
1295185023
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6292 Issued in AL
Practice address
121 E 6TH St
Tuscumbia, AL 35674-2413
Phone
(256) 383-0377
Fax
(256) 383-0745
NPI assigned
Jun 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6292 AL Primary

Addresses

Primary practice location

121 E 6TH St
Tuscumbia, AL 35674-2413

Mailing address

121 E 6TH St
Tuscumbia, AL 35674-2413
Phone (256) 383-0377

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160921000639 AL Order and Referring Only - Other (Non-Physician) 2860789799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6292ALMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
James T. Gardiner Family Dentistry, P.C. Dentist Past Accepting new patients
SRD Tuscumbia PLLC PastSince Jun 26, 2022 Accepting new patients

Organizations & group practices 2

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": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1295185023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 E 6TH ST",
            "city": "TUSCUMBIA",
            "state": "AL",
            "postal_code": "356742413",
            "telephone_number": "256-383-0377",
            "fax_number": "256-383-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E 6TH ST",
            "city": "TUSCUMBIA",
            "state": "AL",
            "postal_code": "356742413",
            "telephone_number": "256-383-0377",
            "fax_number": "256-383-0745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "BRITTANY",
        "middle_name": "ANNE",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscumbia, AL

Sources for this page

Verify at the official NPI Registry.