Gordon B Burnett DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN007288 Issued in GA

Legal business name

GORDON B BURNETT DDS PC

Practice address

1895 Phoenix Blvd
Suite 148
College Park, GA 30349-5533

Phone

(770) 997-4598

Fax

(770) 997-6944

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gordon Berry Burnett Sr., DDSNPI 1134203219

Title

DDS PC President

Phone

(770) 997-4598

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Gordon Berry Burnett Sr., DDS

  • General Practice Dentistry
  • College Park, GA
  • NPI 1134203219
  NPD (past) Authorized official

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881766160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 PHOENIX BLVD",
            "address_2": "SUITE 148",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495533",
            "telephone_number": "770-997-4598",
            "fax_number": "770-997-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 PHOENIX BLVD",
            "address_2": "SUITE 148",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303495533",
            "telephone_number": "770-997-4598",
            "fax_number": "770-997-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON B BURNETT DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "BERRY",
        "authorized_official_title_or_position": "DDS PC PRESIDENT",
        "authorized_official_telephone_number": "770-997-4598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN007288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamyca Goff, ATC, LAT
• Veda Latrice Goins, OWNER
• Golden Beginnings, Inc
• Golden Homecare & Medical Services Inc
• Alan B Goldman
• Judith Loene Gordon
• Charity Sabah Graham
• Ecclesia Luciana Grant, LDO
• Lawanna Tremetrice Gray
• Barbara Lee Green-Muldrow, M.D.

• General Practice Dentistry in College Park, GA
• Providers in College Park, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.