Jay Allen Burleson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS3984 Issued in TN

Practice address

222 Headtown Road
Suite #1
Jonesborough, TN 37659-6175

Phone

(423) 753-9191

Fax

(423) 753-9644

NPI assigned

Jul 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• R Wesley Lauderback DDS PLLC

  dba SmilesDentist

  • Dental Clinic/Center
  • Jonesborough, TN
  • NPI 1679216576
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780604967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 455",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376590455",
            "telephone_number": "423-753-9191",
            "fax_number": "423-753-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 HEADTOWN ROAD",
            "address_2": "SUITE #1",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376596175",
            "telephone_number": "423-753-9191",
            "fax_number": "423-753-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLESON",
        "first_name": "JAY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS3984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inger Buchanan Blanton, LCSW
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Lakyn Bradley, PT DPT
• Gordon Alan Britton Jr., P.A
• Dena Lenore Brown, BCBA
• Amanda A. Cantwell, NP
• Ginger Canty, MED
• Elizabeth Coleman Cates, PH.D.
• Carissa Chambers, O.D.
• Nichole Adriana Chapin, LICSW

• General Practice Dentistry in Jonesborough, TN
• Providers in Jonesborough, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.