Provider Demographics
NPI:1174559934
Name:BURCHENSON, DEAN EARL (DC)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:EARL
Last Name:BURCHENSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 S ASH AVE
Mailing Address - Street 2:STE A-1
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-6837
Mailing Address - Country:US
Mailing Address - Phone:480-750-8900
Mailing Address - Fax:480-750-8905
Practice Address - Street 1:5005 S ASH AVE
Practice Address - Street 2:STE A-1
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-6837
Practice Address - Country:US
Practice Address - Phone:480-750-8900
Practice Address - Fax:480-750-8900
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212407001Medicare PIN