Active NPI
Buruk Kidane
- Driver
- Dallas, TX
National Provider Identifier
1932984226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 061640321
- Practice address
- 5400 Preston Oaks Rd
Dallas, TX 75254-8400 - Phone
- (720) 649-7176
- NPI assigned
- Aug 28, 2023
- Last updated
- Aug 28, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 061640321 | CO | Primary |
Addresses
Primary practice location
5400 Preston Oaks Rd
Dallas, TX 75254-8400
Mailing address
13640 E Kentucky Ave
Aurora, CO 80012-3531
Phone (720) 649-7176
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 |
|---|---|---|---|
| 061640321 | CO | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1932984226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13640 E KENTUCKY AVE",
"city": "AURORA",
"state": "CO",
"postal_code": "800123531",
"telephone_number": "720-649-7176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 PRESTON OAKS RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752548400",
"telephone_number": "720-649-7176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDANE",
"first_name": "BURUK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-28",
"last_updated": "2023-08-28",
"certification_date": "2023-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "CO",
"license": "061640321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.