Michael Adam Burkhardt, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1001365-15 Issued in WI

Practice address

5250 S 108TH St
#200
Hales Corners, WI 53130-1321

Phone

(414) 427-0900

NPI assigned

Jul 19, 2016

Sex

Male

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

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1427401033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 S 108TH ST",
            "address_2": "#200",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301321",
            "telephone_number": "414-427-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 S 108TH ST",
            "address_2": "#200",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301321",
            "telephone_number": "414-427-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHARDT",
        "first_name": "MICHAEL",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001365-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Marie Blomdahl, LPN/RCS
• Emma Blough
• Kyle David Braithwaite, PHARMD
• Richard Edward Brigham, PSY.D.
• Brianna Rae Buehler
• Jennifer Lyn Burton, PH.D.
• Linda Ann Buyan, OTR
• Megan Janelle Byers, D.D.S.
• Sarah Byleen, PHARMD
• Robert I Carpenter, D.C.

• General Practice Dentistry in Hales Corners, WI
• Providers in Hales Corners, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.