Active NPI
Tyler R Burningham, DMD
- Endodontics
- Lacey, WA
National Provider Identifier
1396973418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DE60996227
- Practice address
- 8857 Windham CT NE
Lacey, WA 98516-3884 - Phone
- (801) 671-0340
- NPI assigned
- Jun 26, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 24705 | TX | |
| Endodontics | 1223E0200X | DE60996227 | WA | Primary |
Addresses
Primary practice location
8857 Windham CT NE
Lacey, WA 98516-3884
Mailing address
8857 Windham CT NE
Lacey, WA 98516-3884
Phone (801) 671-0340
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24705 | TX | MD | Dentist |
| DE60996227 | WA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574640000000",
"number": "1396973418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8857 WINDHAM CT NE",
"city": "LACEY",
"state": "WA",
"postal_code": "985163884",
"telephone_number": "801-671-0340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8857 WINDHAM CT NE",
"city": "LACEY",
"state": "WA",
"postal_code": "985163884",
"telephone_number": "801-671-0340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNINGHAM",
"first_name": "TYLER",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-26",
"last_updated": "2019-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "24705",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "WA",
"license": "DE60996227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.