Jacqueline Burgette, DMD, PHD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS041201 Issued in PA

Practice address

3501 Terrace Street
Pittsburgh, PA 15261-7450

Phone

(412) 648-8504

Fax

(412) 383-8662

NPI assigned

Jun 26, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Hom Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509062400000",
    "number": "1710241682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 TERRACE STREET",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152611903",
            "telephone_number": "412-648-8504",
            "fax_number": "412-383-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 TERRACE STREET",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152617450",
            "telephone_number": "412-648-8504",
            "fax_number": "412-383-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGETTE",
        "first_name": "JACQUELINE",
        "credential": "DMD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2017-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS041201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "HOM",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Delores Lucille Burgess, BA
• Ellen Burgess
• Joseph Eli Burgess
• Melissa Amber Burgess, M.D.
• Nicole Helene Burgess
• Alfred J Burgo, MD
• Hannah Jane Cleo Burgoon, MS, RD
• Karen Sue Burgoon, CRNP
• Hira Burhan
• Burk Counseling Services LLC

• Pediatric Dentistry in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.