Burris-Dake LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

BURRIS-DAKE LLC

Doing business as

Poplar Bluff Orthodontics

Practice address

2951 Kanell Blvd
Poplar Bluff, MO 63901-4008

Phone

(573) 776-1355

Fax

(573) 776-1167

NPI assigned

Nov 9, 2010

Last updated

Nov 9, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin G Burris, DDS,MS

Title

Orthodontist

Phone

(573) 776-1355

Specialties & licenses 1

Addresses

Other names 1

• Poplar Bluff Orthodontics Doing business as

Locations

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289260800000",
    "number": "1417258393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2951 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014008",
            "telephone_number": "573-776-1355",
            "fax_number": "573-776-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2951 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014008",
            "telephone_number": "573-776-1355",
            "fax_number": "573-776-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURRIS-DAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A",
        "authorized_official_last_name": "BURRIS",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "15737761355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS,MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poplar Bluff Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly M Burns, FNP-BC
• Kristi Lynn Burns
• Makayla Ann Burns
• Vicki Burns, MSW, LCSW
• Kathy Mae Burpo
• Casey Renae Burris
• Rosie M Burton
• Jaclynn Michelle Burtschi, NRCMA
• Angela Bush, RN
• Butler County EMS LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.