Active NPI
Clarissa Burgess
- Dentist
- Farmington, NM
National Provider Identifier
1326350356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD3324
- Practice address
- 2700 Farmington Ave
Ste C
Farmington, NM 87401-4559 - Phone
- (505) 325-9133
- NPI assigned
- Jul 7, 2010
- Last updated
- Aug 6, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DD3324 | NM | Primary |
Addresses
Primary practice location
2700 Farmington Ave
Ste C
Farmington, NM 87401-4559
Mailing address
8450 Hood Mesa TRL
Farmington, NM 87402-1175
Phone (505) 486-0838
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 |
|---|---|---|---|
| DD3324 | NM | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375747200000",
"number": "1326350356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8450 HOOD MESA TRL",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874021175",
"telephone_number": "505-486-0838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 FARMINGTON AVE",
"address_2": "STE C",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874014559",
"telephone_number": "505-325-9133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "CLARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-07",
"last_updated": "2013-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD3324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.