Provider Demographics
NPI:1093884173
Name:BURKART, JAMES M (DDS PC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:BURKART
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13432 MCKINLEY HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46546
Mailing Address - Country:US
Mailing Address - Phone:574-255-0035
Mailing Address - Fax:574-255-7786
Practice Address - Street 1:13432 MCKINLEY HIGHWAY
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46546
Practice Address - Country:US
Practice Address - Phone:574-255-0035
Practice Address - Fax:574-255-7786
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120089651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice