Individual provider Active NPI

Matthew Burns, D.M.D.

  • Dentist
  • Joint Base Charleston, SC
National Provider Identifier
1689084998
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
635444 Issued in CA
Practice address
204 W Hill Blvd
Joint Base Charleston, SC 29404-4704
Phone
(843) 963-6864
NPI assigned
May 8, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 635444 CA Primary

Addresses

Primary practice location

204 W Hill Blvd
Joint Base Charleston, SC 29404-4704

Mailing address

204 W Hill Blvd
Charleston Afb, SC 29404-4704
Phone (781) 910-6074

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
635444CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1689084998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W HILL BLVD",
            "city": "CHARLESTON AFB",
            "state": "SC",
            "postal_code": "294044704",
            "telephone_number": "781-910-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W HILL BLVD",
            "city": "JOINT BASE CHARLESTON",
            "state": "SC",
            "postal_code": "294044704",
            "telephone_number": "843-963-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "635444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joint Base Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.

Verify at the official NPI Registry.