Shaun Burlingame, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

170582 Issued in CA

Practice address

316 Knollcrest Dr
Redding, CA 96002-0104

Phone

(530) 223-1811

Fax

(530) 223-1813

NPI assigned

May 14, 2014

Last updated

Nov 19, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NY

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

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1932510815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17829 RANCHERA RD",
            "city": "SHASTA LAKE",
            "state": "CA",
            "postal_code": "960198954",
            "telephone_number": "801-718-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 KNOLLCREST DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020104",
            "telephone_number": "530-223-1811",
            "fax_number": "530-223-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURLINGAME",
        "first_name": "SHAUN",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-14",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "170582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Burch Physical Therapy, Inc. (Burch Physical Therapy)
• Bryan Burch, P.T.
• Richard P. Burger Jr.
• Terry Lee Burke, BA
• Dale L Burlingame
• Edith Burnett, MFT
• Jeanette Burton
• Katrina Burton
• Christina Diane Bush, PA-C
• Tina M. Bush

• Oral and Maxillofacial Surgery (Dentist) in Redding, CA
• Providers in Redding, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.