MEDICARE: KATELYN BURBA DMD

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1346179637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN BURBA DMD

Provider Business Mailing Address
First Line	:	100 HUYSHOPE AVE APT 214
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06106-4805
Country	:	US
Telephone Number	:	978-806-1503
Fax Number	:

Provider Business Practice Location Address
First Line	:	129 HIGHLAND AVE
Second Line	:
City	:	SALEM
State	:	MA
Zip	:	01970-2774
Country	:	US
Telephone Number	:	978-703-2008
Fax Number	:

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

Provider Enumeration Date	:	05/14/2026
Last Update Date	:	05/14/2026

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