Eric S Burgess, D.M.D.,F.A.C.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN14265 Issued in FL

Practice address

180 Library Blvd Unit 101
Ponte Vedra Beach, FL 32082-2327

Phone

(904) 273-3001

Fax

(904) 273-9883

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Eric S. Burgess, DMD, PA

  • General Practice Dentistry
  • Ponte Vedra Beach, FL
  • NPI 1619797461
  NPD

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1477573731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 LIBRARY BLVD UNIT 101",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320822327",
            "telephone_number": "904-273-3001",
            "fax_number": "904-273-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 LIBRARY BLVD UNIT 101",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320822327",
            "telephone_number": "904-273-3001",
            "fax_number": "904-273-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "ERIC",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D.,F.A.C.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "14265",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alexis Buster, RBT
• Daniel M Calloway, MD
• Katie Longo Cantrell, MD
• Mark A Cappel, MD

• General Practice Dentistry in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.