Moffett Kable Burgess, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE00009652 Issued in WA

Practice address

4400 37TH Ave S
Dental Clinic
Seattle, WA 98118-1609

Phone

(206) 205-6003

NPI assigned

Nov 14, 2006

Sex

Female

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 1

Other names 1

• Ms. Moffett Lee Kable Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mburgess119641@direct.ochin.org

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1891867883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 2ND AVE W",
            "address_2": "COTTAGE HOUSE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981192624",
            "telephone_number": "206-852-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 37TH AVE S",
            "address_2": "DENTAL CLINIC",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181609",
            "telephone_number": "206-205-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGESS",
        "first_name": "MOFFETT",
        "middle_name": "KABLE",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00009652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5044987",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOFFETT",
            "last_name": "KABLE",
            "middle_name": "LEE",
            "prefix": "MS.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andrea Alys Burgess, PA-C
• Connor Burgess
• Deanna Burgess, M.ED
• Emma Rose Burgess
• Leslie Virginia Burgess, N.D.
• Emily Burgett
• Patricia Ellen Burgin, MFT
• Mikaela Soledad Burgos Cando
• Pallas Burhen
• Elena Grace Buri

• Dentist in Seattle, WA
• Providers in Seattle, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.