Brad R. Burks, D.M.D., P.C.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

BRAD R. BURKS, D.M.D., P.C.

Doing business as

Ozark Mountain Periodontics

Practice address

1355 E Bradford Pkwy
Ste D
Springfield, MO 65804

Phone

(417) 882-4600

Fax

(417) 882-1677

NPI assigned

Aug 25, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Brad Reese Burks, D.M.D.NPI 1295743318

Title

President

Phone

(417) 882-4600

Specialties & licenses 1

Addresses

Other names 1

• Ozark Mountain Periodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brad Reese Burks, DMD

  • Periodontics
  • Springfield, MO
  • NPI 1295743318
  NPD (past) Authorized official

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1770368177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 E BRADFORD PKWY",
            "address_2": "STE D",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65804",
            "telephone_number": "417-882-4600",
            "fax_number": "417-882-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 E BRADFORD PKWY",
            "address_2": "STE D",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65804",
            "telephone_number": "417-882-4600",
            "fax_number": "417-882-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAD R. BURKS, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "BURKS",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "REESE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-882-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ozark Mountain Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carrie Rae Bozworth
• BPD South LLC
• John H. Brabson, MD
• Tiffany Anne Bracamonte, NP
• Jonetta Bracken, LCSW CSAC
• Danielle R. Braden-Moll, RD, LD, CDE
• Jacob Braden, MS, PLPC
• Bradford Place Surgery and Laser Center, LLC
• Heather Bradford, FNP
• Mark Lavelle Bradford

• Periodontics in Springfield, MO
• Providers in Springfield, MO by specialty
• Periodontics in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.