Mary Hagan Burke, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

012706 Issued in MO

Practice address

5600 Oakland Ave
Dental Hygiene St Louis Community College-Forest Park
Saint Louis, MO 63110-1393

Phone

(314) 644-9630

Fax

(314) 951-9490

NPI assigned

May 21, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1417166000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 WOODLEIGH CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631224805",
            "telephone_number": "314-821-2588",
            "fax_number": "314-821-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 OAKLAND AVE",
            "address_2": "DENTAL HYGIENE ST LOUIS COMMUNITY COLLEGE-FOREST PARK",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101393",
            "telephone_number": "314-644-9630",
            "fax_number": "314-951-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKE",
        "first_name": "MARY",
        "middle_name": "HAGAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "012706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree Michelle Burke, MSW
• Helene Y Burke, APRN, FNP-C
• James Benjamin Burke III, MD
• James S Burke Jr., M.D.
• Lauren Burke, CPNP
• Matthew Frederic Burke, MD
• Michelle Lynn Burke
• William Joseph Burke, MD
• Claire Elizabeth Burkemper, MSW, LCSW
• Nicole M Burkemper, M.D.

• Periodontics in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Periodontics in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.