Brad Reese Burks, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DE014923 Issued in MO

Practice address

1355 E Bradford Pkwy Ste D
Springfield, MO 65804-4200

Phone

(417) 882-4600

Fax

(417) 882-1677

NPI assigned

Aug 4, 2006

Sex

Male

Sole proprietor

Yes

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 MO

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

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.

• Brad R. Burks, D.M.D., P.C.

  • Periodontics
  • Springfield, MO
  • NPI 1770368177
  NPD (past) Authorized official
• Burks & Bryant, LLC

  • Periodontics
  • Springfield, MO
  • NPI 1407719859
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295743318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 E BRADFORD PKWY STE D",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044200",
            "telephone_number": "417-882-4600",
            "fax_number": "417-882-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 E BRADFORD PKWY STE D",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044200",
            "telephone_number": "417-882-4600",
            "fax_number": "417-882-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKS",
        "first_name": "BRAD",
        "middle_name": "REESE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "DE014923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcie Burk, MS, LPC
• Lori Marie Burkard
• Daniel J Burke, D.O.
• Juliann Makayla Lee Burke
• Burks & Bryant, LLC
• Breanna R. Burks, PA-C
• Donalyn Jody Burks, LMT
• Justin Burks, FNP
• Tara Burks, LPT
• Katherine Burley, MSW

• Periodontics in Springfield, MO
• Providers in Springfield, MO by specialty
• Periodontics in Missouri

• 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.
• 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.