MEDICARE: DR. JEFFREY S BURNS DDS

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
1	1223G0001X	General Practice Dentistry	040100-8104	VA

General Provider Information

NPI Number	:	1043245806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY S BURNS DDS

Provider Business Mailing Address
First Line	:	9626 S CONGRESS ST
Second Line	:
City	:	NEW MARKET
State	:	VA
Zip	:	22844-9450
Country	:	US
Telephone Number	:	540-740-8937
Fax Number	:	540-740-9227

Provider Business Practice Location Address
First Line	:	9626 S CONGRESS ST
Second Line	:
City	:	NEW MARKET
State	:	VA
Zip	:	22844-9450
Country	:	US
Telephone Number	:	540-740-8937
Fax Number	:	540-740-9227

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	05/23/2019

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