NPIMap

Organization Active NPI

Kent Burnett DDS

  • General Practice Dentistry
  • Corvallis, OR
National Provider Identifier
1396010575
Registry record updated Mar 20, 2012
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7437 Issued in OR
Legal business name
KENT BURNETT DDS
Practice address
1711 NW Grant Ave
Corvallis, OR 97330-2642
Phone
(541) 754-1668
Fax
(541) 758-3010
NPI assigned
Mar 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Authorized official

Name
Dr. Kent Douglas Burnett, DDS
Title
Owner/Dentist
Phone
(541) 754-1668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D7437 OR Primary

Addresses

Primary practice location

1711 NW Grant Ave
Corvallis, OR 97330-2642

Mailing address

1711 NW Grant Ave
Corvallis, OR 97330-2642
Phone (541) 754-1668

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1396010575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 NW GRANT AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973302642",
            "telephone_number": "541-754-1668",
            "fax_number": "541-758-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 NW GRANT AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973302642",
            "telephone_number": "541-754-1668",
            "fax_number": "541-758-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT BURNETT DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "541-754-1668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.