Jerry W. Burleson is a Dentist in Portsmouth, Ohio. Jerry W. Burleson practices all healthcare services and medical treatments related to Dentist. The NPI Number for Jerry W. Burleson is 1104941541. The last update date is 2007-07-09.
Jerry W. Burleson's current location address is 1500 Grant St, Portsmouth, Ohio. You can contact this provider via phone number 7403543395 and fax number 7403538405. The mailing address for Jerry W. Burleson is 1500 Grant St, Portsmouth, Ohio. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerry W. Burleson |
|---|---|
| Address | 1500 Grant St, Portsmouth, Ohio |
| Phone Number | 7403543395 |
| Fax Number | 7403538405 |
| Sole Proprietor | N |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1104941541 |
|---|---|
| Provider Enumeration Date | 2007-03-21 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 1500 Grant St |
|---|---|
| City | Portsmouth |
| State | Ohio (OH) |
| Post Code | 456623606 |
| Phone Number | 7403543395 |
| Fax Number | 7403538405 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 15628 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 355511 | OH | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Jerry W. Burleson by the Centers for Medicare & Medicaid Services?
The Jerry W. Burleson has been issued the NPI (National Provider Identifier) 1104941541 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete address where Jerry W. Burleson is physically located?
The Jerry W. Burleson is situated at the following address: 1500 Grant St, Portsmouth, OH 456623606.
What is the Jerry W. Burleson's specialty and taxonomy code?
The Jerry W. Burleson's specialty is Dentist, and the corresponding taxonomy code is 122300000X.
On what date did the Jerry W. Burleson receive the assignment of its 1104941541 from the Centers for Medicare & Medicaid Services?
The Jerry W. Burleson was issued its 1104941541 by the Centers for Medicare & Medicaid Services on 2007-03-21.
When was the information pertaining to Jerry W. Burleson most recently updated or revised?
The details related to Jerry W. Burleson, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-09.
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