Richard Burton

Individual provider Active NPI Dentist · Parlin, NJ

NPI 1639237282 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1639237282
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
13557 (NJ)
Practice address
777 Washington Road
Parlin, NJ 08859-1074
Phone
(732) 257-2000
Fax
(732) 257-2606
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240102003085 NJ Order and Referring Only - Dentist
Practitioner - Dentist
0143500520

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
13557NJMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13557 NJ Yes

Addresses

Primary practice location

777 Washington Road
Parlin, NJ 08859-1074

Mailing address

114 Gertrude Street
Clark, NJ 07066
Phone (732) 673-1574

Other providers in Parlin, NJ

All providers in Parlin, NJ · Dentist in New Jersey

Sources for this page

Verify at the official NPI Registry.