Provider Demographics
NPI:1093889230
Name:DONALD E BURK DMD PC
Entity Type:Organization
Organization Name:DONALD E BURK DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:BURK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:907-562-6456
Mailing Address - Street 1:2805 DAWSON STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503
Mailing Address - Country:US
Mailing Address - Phone:907-562-6456
Mailing Address - Fax:907-562-0009
Practice Address - Street 1:2805 DAWSON STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-562-6456
Practice Address - Fax:907-562-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKDD0208Medicaid