Healthcare Provider Details

I. General information

NPI: 1851480248
Provider Name (Legal Business Name): JAMES A BURDEN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 MCLAWS CR.
WILLIAMSBURG VA
23185-5645
US

IV. Provider business mailing address

277 MCLAWS CIR
WILLIAMSBURG VA
23185-5645
US

V. Phone/Fax

Practice location:
  • Phone: 757-229-1224
  • Fax: 757-220-2414
Mailing address:
  • Phone: 757-229-1224
  • Fax: 757-220-2414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401007315
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: