Burgett Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BURGETT DENTAL CORPORATION

Practice address

4541 College Ave
San Diego, CA 92115-4010

Phone

(619) 582-6000

Fax

(619) 582-6002

NPI assigned

Mar 18, 2015

Organization subpart

No

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

Authorized official

Name

Ray Bahae

Title

Partner

Phone

(858) 361-3322

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1396139127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4541 COLLEGE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154010",
            "telephone_number": "619-582-6000",
            "fax_number": "619-582-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 COLLEGE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154010",
            "telephone_number": "619-582-6000",
            "fax_number": "619-582-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURGETT DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-18",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "BAHAE",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "858-361-3322"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malia Alys Burgess, PTA
• Margaret Lois Gurman Burgess, LCSW
• Matthew Daniel Burgess, MD
• Spencer Burgess
• Toni Burgess
• Melinda Burgett
• Alina Burgi, M.P.H., B.S.N., R.N.
• Johnathan Burgi
• Annmarie Burgo
• Andres Manuel Burgoin, B.A., RBT

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; 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.