MEDICARE: DR. RICHARD HOWARD BURNS JR. 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
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	30-018166	OH
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN23132	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1073643656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD HOWARD BURNS JR. D.D.S.

Provider Business Mailing Address
First Line	:	1102 BLACKWOLF RUN RD
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33896-7952
Country	:	US
Telephone Number	:	330-340-5259
Fax Number	:

Provider Business Practice Location Address
First Line	:	7975 OSCEOLA POLK LINE RD
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33896-9104
Country	:	US
Telephone Number	:	863-591-0402
Fax Number	:

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	02/25/2025

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Directions to “ DR. RICHARD HOWARD BURNS JR. D.D.S.” Practice Location

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