Kevin D. Burgdorf DDS LLC

Primary specialty

DentistTaxonomy code 122300000X

License

2009008266 Issued in MO

Legal business name

KEVIN D. BURGDORF DDS LLC

Practice address

12266 Depaul Drive
Suite 325
Bridgeton, MO 63044-2514

Phone

(314) 291-9000

Fax

(314) 291-0590

NPI assigned

Sep 10, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Kevin D Burgdorf, DDS

Title

Owner

Phone

(314) 291-9000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1689042467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12266 DEPAUL DRIVE",
            "address_2": "SUITE 325",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442514",
            "telephone_number": "314-291-9000",
            "fax_number": "314-291-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12266 DEPAUL DRIVE",
            "address_2": "SUITE 325",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442514",
            "telephone_number": "314-291-9000",
            "fax_number": "314-291-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN D. BURGDORF DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "BURGDORF",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-291-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "2009008266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrianna Kelmendi, MD
• Jennifer K Kemp, PMHNP
• Andrew Kendrick, MA, LPC, NCC
• Sarah Kennedy, MD
• Jessica Kent, PHARM D.
• Kennedi Keyes, MHS, CCC-SLP
• Julie Kicklighter, M.ED.
• Kevin J Kidd
• William P Killeen, CRNA
• Austin Kim

• Dentist in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.