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NPI Code Detail

MEDICARE: DR. ANGELA G. BURKE D.D.S.

MEDICARE:  DR. ANGELA G. BURKE  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist12009907IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639392301
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA G. BURKE D.D.S.
Provider Business Mailing Address
First Line : 1471 CHESTER BLVD STE B
Second Line :
City : RICHMOND
State : IN
Zip : 47374-1946
Country : US
Telephone Number : 765-962-4774
Fax Number : 765-962-4774
Provider Business Practice Location Address
First Line : 1471 CHESTER BLVD STE B
Second Line :
City : RICHMOND
State : IN
Zip : 47374-1946
Country : US
Telephone Number : 765-962-4774
Fax Number : 765-962-4774
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 12/22/2020

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Directions to “ DR. ANGELA G. BURKE D.D.S.” Practice Location

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