MEDICARE: BRIANNA PAIGE BURKS

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	122400000X	Denturist	DT-TMP-10263339	OR

General Provider Information

NPI Number	:	1275496077
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA PAIGE BURKS

Provider Business Mailing Address
First Line	:	1710 E PINE ST
Second Line	:
City	:	CENTRAL POINT
State	:	OR
Zip	:	97502-2811
Country	:	US
Telephone Number	:	541-665-1112
Fax Number	:

Provider Business Practice Location Address
First Line	:	1710 E PINE ST
Second Line	:
City	:	CENTRAL POINT
State	:	OR
Zip	:	97502-2811
Country	:	US
Telephone Number	:	541-665-1112
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ BRIANNA PAIGE BURKS ” Practice Location

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