Individual provider Active NPI

Kerin L Burdette, DDS

  • Pediatric Dentistry
  • Duncanville, TX
National Provider Identifier
1396795381
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
25187 Issued in TX
Practice address
400 E US Hwy 67
Duncanville, TX 75137
Phone
(214) 339-5150
Fax
(214) 339-5151
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 015946 MO
General Practice Dentistry 1223G0001X 5170 AZ
General Practice Dentistry 1223G0001X 019-26330 IL
General Practice Dentistry 1223G0001X 6787 NE
Pediatric Dentistry 1223P0221X 25187 TX Primary

Addresses

Primary practice location

400 E US Hwy 67
Duncanville, TX 75137

Mailing address

400 E US Hwy 67
Duncanville, TX 75137
Phone (214) 339-5150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-26330ILMDGeneral Practice Dentistry
015946MOMDGeneral Practice Dentistry
25187TXMDPediatric Dentist
6787NEMDInternal Medicine Physician
5170AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Donna J Barefield DDS PC Pediatric Dentistry Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: burdette.kerin.p1@direct.lbucc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1396795381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E US HWY 67",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "75137",
            "telephone_number": "214-339-5150",
            "fax_number": "214-339-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E US HWY 67",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "75137",
            "telephone_number": "214-339-5150",
            "fax_number": "214-339-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDETTE",
        "first_name": "KERIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "015946",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5170",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-26330",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6787",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "25187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncanville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; 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.