Active NPI
David Mosher Burrus, DDS
- Pediatric Dentistry
- Redmond, OR
National Provider Identifier
1881986859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D9699
- Practice address
- 413 NW Larch Ave
Suite 201
Redmond, OR 97756-1361 - Phone
- (541) 923-8666
- NPI assigned
- May 10, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6662-15 | WI | |
| Pediatric Dentistry | 1223P0221X | D9699 | OR | Primary |
Addresses
Primary practice location
413 NW Larch Ave
Suite 201
Redmond, OR 97756-1361
Mailing address
2379 NW Labiche LN
# 1
Bend, OR 97701-7178
Phone (541) 280-4835
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6662-15 | WI | MD | General Practice Dentistry |
| D9699 | OR | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burrus Dentistry PC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412035200000",
"number": "1881986859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2379 NW LABICHE LN",
"address_2": "# 1",
"city": "BEND",
"state": "OR",
"postal_code": "977017178",
"telephone_number": "541-280-4835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 NW LARCH AVE",
"address_2": "SUITE 201",
"city": "REDMOND",
"state": "OR",
"postal_code": "977561361",
"telephone_number": "541-923-8666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRUS",
"first_name": "DAVID",
"middle_name": "MOSHER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-10",
"last_updated": "2014-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "6662-15",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OR",
"license": "D9699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redmond, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.