Individual provider Active NPI

Kristin Carazola Burch, DDS

  • Dentist
  • Palm Harbor, FL
National Provider Identifier
1689018541
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13840 Issued in FL
Practice address
4854 Ridgemoor Blvd
Palm Harbor, FL 34685-1742
Phone
(727) 789-8900
Fax
(727) 789-1029
NPI assigned
Apr 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13840 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
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13840FLMDDentist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1689018541",
    "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": "KRISTIN",
        "middle_name": "CARAZOLA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "13840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.