Myeasha Kharima Burgess, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3768-14 Issued in MS

Practice address

949 Broadway Dr
Hattiesburg, MS 39401-7534

Phone

(601) 620-0075

Fax

(601) 620-0105

NPI assigned

Sep 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Sparkling Smiles Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Hattiesburg, MS
  • NPI 1881279016
  NPD Authorized official
• Small Smiles of Cincinnati, LLC

  • General Practice Dentistry
  • Cincinnati, OH
  • NPI 1326097569
  NPD (past)

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1356599237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 BROADWAY DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017534",
            "telephone_number": "601-620-0075",
            "fax_number": "601-620-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 BROADWAY DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017534",
            "telephone_number": "601-620-0075",
            "fax_number": "601-620-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "MYEASHA",
        "middle_name": "KHARIMA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14641",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1000754",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.023795",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MS",
            "license": "3768-14",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lewis A Bullock, NCC
• Kimberly Bunch-Crump, PH.D., BCBA
• Steven Burch, LPTA
• Devontre Stephon Burdette
• Justin Bryce Burge
• Ruth M Burgess, PT
• Terry Burgess
• Lashontay Burkett
• Peyton Burks, DMD
• Scott G Burks, MD

• All providers in Hattiesburg, MS
• Pediatric Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.