Jonathan W Burton, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

021-002074 Issued in IL

Practice address

2250 N Reed Station Rd
Suite 201
Carbondale, IL 62901-8101

Phone

(618) 519-9363

Fax

(618) 519-9364

NPI assigned

Oct 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 30, 2013 through Nov 30, 2027

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Shawnee Hills Oral & Maxillofacial Surgery, SC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Carbondale, IL
  • NPI 1538394556
  NPD (past) Authorized official
• Southern Illinois Oral & Maxillofacial Surgery, LTD.

  • Oral and Maxillofacial Surgery (Dentist)
  • Belleville, IL
  • NPI 1538180617
  NPD (past)

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243382400000",
    "number": "1710974795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 N REED STATION RD",
            "address_2": "SUITE 201",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629018101",
            "telephone_number": "618-519-9363",
            "fax_number": "618-519-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 N REED STATION RD",
            "address_2": "SUITE 201",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629018101",
            "telephone_number": "618-519-9363",
            "fax_number": "618-519-9364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTON",
        "first_name": "JONATHAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2009-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-026124",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021-002074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah M. D. Buila, MSW, LCSW, PH.D.
• Ahmed Bukhamsin, BS
• Burke Behavioral Health, LLC
• Sharon Saum Burruss, O.D.
• Monica Burtley-Miller, LCSW
• Warren Thomas Bush, PH.D.
• Kelly A Bushur, CP PH.D
• Bethany Butler, CRNA
• Mazhar M. Butt, DMD
• Raheem Butt, DMD

• Oral and Maxillofacial Surgery (Dentist) in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.