Individual provider Active NPI

Randall Stanley Burba, DMD

  • General Practice Dentistry
  • Salem, MA
National Provider Identifier
1952330516
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18762 Issued in MA
Practice address
129 Highland Ave
Salem, MA 01970-2774
Phone
(978) 744-7575
Fax
(978) 744-8577
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18762 MA Primary

Addresses

Primary practice location

129 Highland Ave
Salem, MA 01970-2774

Mailing address

129 Highland Ave
Salem, MA 01970-2774
Phone (978) 744-7575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20150407001713 MA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6406174218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18762MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Burba Dental Partners Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952330516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702774",
            "telephone_number": "978-744-7575",
            "fax_number": "978-744-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 HIGHLAND AVE",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019702774",
            "telephone_number": "978-744-7575",
            "fax_number": "978-744-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURBA",
        "first_name": "RANDALL",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "18762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.