NPIMap

Organization Active NPI

Burrus Dentistry PC

Doing business as Pediatric Dental Associates

  • Pediatric Dentistry
  • Redmond, OR
National Provider Identifier
1912304528
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
BURRUS DENTISTRY PC
Doing business as
Pediatric Dental Associates
Practice address
413 NW Larch Ave
Suite 201
Redmond, OR 97756-1361
Phone
(541) 923-8666
NPI assigned
Nov 25, 2014
Last updated
Nov 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Authorized official

Name
Dr. Elise Poremski Burrus, DDSNPI 1649583428
Title
Pediatric Dentist
Phone
(541) 923-8666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

413 NW Larch Ave
Suite 201
Redmond, OR 97756-1361

Mailing address

413 NW Larch Ave
Suite 201
Redmond, OR 97756-1361
Phone (541) 923-8666

Other names 1

  • Pediatric Dental Associates Doing business as

National Provider Directory

National Provider Directory

Locations

413 NW Larch Ave
Ste 201
Redmond, OR 97756
Phone (414) 923-8666

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1912304528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": {
        "organization_name": "BURRUS DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "BURRUS",
        "authorized_official_first_name": "ELISE",
        "authorized_official_middle_name": "POREMSKI",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "541-923-8666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 25, 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.

Verify at the official NPI Registry.