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General NPI Number Information
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NPI Number | 1215249982
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Entity Type | Individual
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Provider Name | BRANDON GLEN BURKE D.D.S., M.S.D.
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Gender | Male
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 3068 SWAPS DR
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City | SAINT GEORGE
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State | UT
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Zip | 84790-7468
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Country | US
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Telephone | 435-705-3461
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Fax |
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Provider Business Mailing Address
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Address Line | 3068 SWAPS DR
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City | SAINT GEORGE
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State | UT
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Zip | 84790-7468
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Country | US
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Telephone | 435-705-3461
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | S3-295C
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 7598338-9921
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401412136
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 112653
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License Number State | CA
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