Active NPI
Elyse Nicole Burkert, DDS
- General Practice Dentistry
- Rockwall, TX
National Provider Identifier
1649763194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 34173
- Practice address
- 2268 N Lake Shore Dr Ste 104
Rockwall, TX 75087-0280 - Phone
- (469) 616-0507
- NPI assigned
- Jun 10, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 34173 | TX | Primary |
Addresses
Primary practice location
2268 N Lake Shore Dr Ste 104
Rockwall, TX 75087-0280
Mailing address
401 Arborcrest Dr
Richardson, TX 75080-2607
Phone (972) 841-8043
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34173 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528588800000",
"number": "1649763194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 ARBORCREST DR",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750802607",
"telephone_number": "972-841-8043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2268 N LAKE SHORE DR STE 104",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750870280",
"telephone_number": "469-616-0507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURKERT",
"first_name": "ELYSE",
"middle_name": "NICOLE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-10",
"last_updated": "2018-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "34173",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockwall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.