Individual provider Active NPI

David Randolf Burch, DDS

  • Dentist
  • Palm Harbor, FL
National Provider Identifier
1467896696
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13871 Issued in FL
Practice address
4854 Ridgemoor Blvd
Palm Harbor, FL 34685-1742
Phone
(727) 789-8900
Fax
(727) 789-1029
NPI assigned
Apr 18, 2013
Last updated
Apr 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13871 FL Primary

Addresses

Primary practice location

4854 Ridgemoor Blvd
Palm Harbor, FL 34685-1742

Mailing address

4854 Ridgemoor Blvd
Palm Harbor, FL 34685-1742
Phone (727) 789-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170127002560 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3577845494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13871FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgemoor Dental Arts, Inc. Dentist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1467896696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4854 RIDGEMOOR BLVD",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346851742",
            "telephone_number": "727-789-8900",
            "fax_number": "727-789-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4854 RIDGEMOOR BLVD",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346851742",
            "telephone_number": "727-789-8900",
            "fax_number": "727-789-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCH",
        "first_name": "DAVID",
        "middle_name": "RANDOLF",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-18",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "13871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.