Burton A Coleman, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

9567 Issued in TN

Practice address

2309 Rudolphtown Rd
Ste B
Clarksville, TN 37043-2228

Phone

(931) 259-4400

Fax

(931) 259-4401

NPI assigned

Sep 25, 2012

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 21, 2021 through Jun 21, 2027

Medicare enrollment (NPD)

Not 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.

• Heritage Endodontics

  • Endodontics
  • Clarksville, TN
  • NPI 1043699796
  NPD (past) Authorized official

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1306197884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 RUDOLPHTOWN RD",
            "address_2": "STE B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370432228",
            "telephone_number": "931-259-4400",
            "fax_number": "931-259-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 RUDOLPHTOWN RD",
            "address_2": "STE B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370432228",
            "telephone_number": "931-259-4400",
            "fax_number": "931-259-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "BURTON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-25",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "9567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keyana Cole
• Linda D. Cole, RN
• Lori Lynn Cole, M.A.
• Starlette Charmaine Cole
• Terry M. Cole, D.PH.
• Erica Coleman, BACHELORS IN SCIENCE
• Jessica Coleman, NP
• Kara Coleman, DO
• Tianna Coleman
• Jamie Coles, RBT

• Dentist in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.