Healthcare Provider Details

I. General information

NPI: 1831365352
Provider Name (Legal Business Name): NIKIA R BURNS D.M.D., M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 12/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 WASHINGTON RD
MC MURRAY PA
15317-2543
US

IV. Provider business mailing address

4050 WASHINGTON RD
MC MURRAY PA
15317-2543
US

V. Phone/Fax

Practice location:
  • Phone: 724-833-0417
  • Fax: 724-941-0467
Mailing address:
  • Phone: 724-833-0417
  • Fax: 724-941-0467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS037128
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN17125
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number3689
License Number StateWV

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: