Individual provider Active NPI

Joseph Bruce Burley, D.D.S.

  • General Practice Dentistry
  • Hagerstown, MD
National Provider Identifier
1346268182
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9208 Issued in MD
Practice address
1115 Mount Aetna Road
Hagerstown, MD 21740
Phone
(301) 739-7003
Fax
(301) 739-7910
NPI assigned
Jul 18, 2006
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9208 MD
General Practice Dentistry 1223G0001X 9208 MD Primary

Addresses

Primary practice location

1115 Mount Aetna Road
Hagerstown, MD 21740

Mailing address

1115 Mount Aetna Road
Hagerstown, MD 21740
Phone (301) 739-7003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20150608002145 MD Order and Referring Only - DentistPractitioner - Dentist 8527389105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hagerstown Smiles Dental Care, PA CurrentSince Jun 12, 2022 Accepting new patients

Locations

1115 Mount Aetna Rd
Hagerstown, MD 21740
Phone (301) 739-7003

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1346268182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 MOUNT AETNA ROAD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21740",
            "telephone_number": "301-739-7003",
            "fax_number": "301-739-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 MOUNT AETNA ROAD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21740",
            "telephone_number": "301-739-7003",
            "fax_number": "301-739-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLEY",
        "first_name": "JOSEPH",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "9208",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "9208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.