Grayson John Burgardt, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D010692 Issued in AZ

Practice address

13260 N 94TH Dr Ste 410
Peoria, AZ 85381-4241

Phone

(620) 260-5655

NPI assigned

Apr 12, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Locations

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.

• Burgardt and Diaz Dental Group, PLLC

  • Periodontics
  • Peoria, AZ
  • NPI 1972128858
  NPD Authorized official

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1326481995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6519 E BLUEFIELD AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850546741",
            "telephone_number": "620-260-5655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13260 N 94TH DR STE 410",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814241",
            "telephone_number": "620-260-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGARDT",
        "first_name": "GRAYSON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-12",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28733",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "D010692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Bunjovac, FNP-C
• Jennifer Buonano, DC
• Mary Kate Burdick, DVM
• Melissa Burdick, PHARM.D.
• Burgardt and Diaz Dental Group, PLLC
• Jodi Burgess, PHARMD
• Roxanne Burgos
• Justin Burke
• Michael Burke, LCSW
• Robert Ray Burnham Jr., M.D.

• Periodontics in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Periodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; 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.