Stephanie Lynn Burroughs, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

050216 Issued in NY

Practice address

74 W Main St
Avon, NY 14414-1136

Phone

(585) 226-3113

NPI assigned

Sep 28, 2006

Last updated

May 12, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1366533887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 W MAIN ST",
            "city": "AVON",
            "state": "NY",
            "postal_code": "144141136",
            "telephone_number": "585-226-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 W MAIN ST",
            "city": "AVON",
            "state": "NY",
            "postal_code": "144141136",
            "telephone_number": "585-226-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "050216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02348772",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenna Brady
• Sandra Joy Brice Ballew, R.N.
• Shantal R Briscoe, RN
• Steven Richard Bruno, DDS
• Christian Grant Burger
• Heather Carroll
• Julia Kathryn Carson, PA-C
• Charles Shaw (Avon Chiropractic)
• Joanna Collins, LPN
• Deborah Coniglio, FNP

• Dentist in Avon, NY
• Providers in Avon, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.