Dennis Bourkov, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

85402 Issued in CA

Practice address

781 South Highway 49
Jackson, CA 95642

Phone

(209) 223-9670

NPI assigned

Feb 1, 2022

Last updated

Feb 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Raleys

  • Community/Retail Pharmacy
  • Galt, CA
  • NPI 1174633820
  NPD (past)
• Raleys

  • Community/Retail Pharmacy
  • Jackson, CA
  • NPI 1285744946
  NPD (past)

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1699428417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15241 DE LA CRUZ DR",
            "city": "RANCHO MURIETA",
            "state": "CA",
            "postal_code": "956839717",
            "telephone_number": "915-467-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 SOUTH HIGHWAY 49",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "95642",
            "telephone_number": "209-223-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURKOV",
        "first_name": "DENNIS",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "85402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "85402",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Bianchi, PPS - SCHOOL PSYCHOL
• Christine Anne Bitler, LCSW
• Gerard V. Bland, MD
• Blue Mountain Transit
• April Michelle Boitano, C.N.M, W.H.N.P
• Thomas Alan Bowhay, M.D.
• Brad Chew MD Inc
• Shawn K. Brady, MD
• Belinda Lynnette Braggs, M.D.
• Kelly Breeding

• Pharmacist in Jackson, CA
• Providers in Jackson, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.