Spencer Drew Burnett, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN12282 Issued in FL

Practice address

Phoenix Indian Medical Center Att: Dental
4212 N. 16TH Street
Phoenix, AZ 85016

Phone

(602) 263-1200

Fax

(602) 263-1608

NPI assigned

Oct 5, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in TX

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  • Public Health or Welfare Agency
  • Phoenix, AZ
  • NPI 1083643738

  TX

  Medicare reassignment NPD
• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  • Public Health or Welfare Agency
  • Maricopa, AZ
  • NPI 1538043443
  NPD

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851487987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PHOENIX INDIAN MEDICAL CENTER ATT: DENTAL",
            "address_2": "4212 N. 16TH STREET",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85016",
            "telephone_number": "602-263-1200",
            "fax_number": "602-263-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PHOENIX INDIAN MEDICAL CENTER ATT: DENTAL",
            "address_2": "4212 N. 16TH STREET",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85016",
            "telephone_number": "602-263-1200",
            "fax_number": "602-263-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNETT",
        "first_name": "SPENCER",
        "middle_name": "DREW",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN12282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "AZ0419140",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621393",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alecia Burnett, DC
• Anna Burnett, LPC
• Genise Burnett
• Martin Burnett, M.D.
• Riana Burnett, LCSW
• Tara Burnett, LPN
• Timothy Brett Burnett, CRNA
• Alexis Michelle Burnette, MD
• Alexandra Kristen Sales Burnham, DMD
• Susan D Burnham, P.T.

• Pediatric Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatric Dentistry in Arizona

• 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.
• 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.