Bryan Hall Burdette, DMD, MS

Primary specialty

DentistTaxonomy code 122300000X

License

4567 Issued in KY

Practice address

13050 Magisterial Dr
Suite 100
Louisville, KY 40223-5180

Phone

(502) 245-1061

Fax

(502) 245-1065

NPI assigned

Jul 1, 2005

Last updated

Mar 23, 2010By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bryan Hall Burdette

  • Dentist
  • Louisville, KY
  • NPI 1487061081
  NPD (past)

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1942207238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13050 MAGISTERIAL DR",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235180",
            "telephone_number": "502-245-1061",
            "fax_number": "502-245-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13050 MAGISTERIAL DR",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235180",
            "telephone_number": "502-245-1061",
            "fax_number": "502-245-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURDETTE",
        "first_name": "BRYAN",
        "middle_name": "HALL",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "4567",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4567",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000000050182",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connie Sue Burcin, COTA/L
• Elizabeth R. Burckardt, ARNP
• Elizabeth Self Burckardt, MD
• Megan Elizabeth Burd, PHARMD
• Allison Nicole Burdenmeyer
• Emily Austin Burdette
• Hannah Danielle Burdette, MS, OTR/L
• Kayla Marie Dawna Burdette
• Nicole Burdette
• Mary Catherine Burdge

• Dentist in Louisville, KY
• Providers in Louisville, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; 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.