Individual provider Active NPI

Norma Ubalde Burnley, D.D.S., D.M.D.

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1457645780
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1022 Issued in NV
Practice address
5140 S Eastern Ave
Las Vegas, NV 89119-2305
Phone
(702) 891-0079
Fax
(702) 891-0455
NPI assigned
Jun 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1022 NV Primary

Addresses

Primary practice location

5140 S Eastern Ave
Las Vegas, NV 89119-2305

Mailing address

5140 S Eastern Ave
Las Vegas, NV 89119-2305
Phone (702) 891-0079

Other identifiers 1

IdentifierTypeStateIssuer
1022OtherNVDENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20160217000273 NV Order and Referring Only - DentistPractitioner - Dentist 0244535003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1022NVMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Norma U. Burnley,D.D.S.,D.M.D.,LTD Past Accepting new patients

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": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1457645780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891192305",
            "telephone_number": "702-891-0079",
            "fax_number": "702-891-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891192305",
            "telephone_number": "702-891-0079",
            "fax_number": "702-891-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNLEY",
        "first_name": "NORMA",
        "middle_name": "UBALDE",
        "name_prefix": "Dr.",
        "credential": "D.D.S., D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-03",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "1022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "1022",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.