Provider Demographics
NPI:1235510355
Name:BURKETT, DANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:
Last Name:BURKETT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3832
Mailing Address - Country:US
Mailing Address - Phone:585-203-4981
Mailing Address - Fax:
Practice Address - Street 1:245 FIRST ST
Practice Address - Street 2:18TH FLOOR
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02142-1200
Practice Address - Country:US
Practice Address - Phone:888-833-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856662122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist