Provider Demographics
NPI:1356314314
Name:BURKE, DINA SANTO TOMAS (MD)
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:SANTO TOMAS
Last Name:BURKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7455 W WASHINGTON AVE STE 422
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4347
Mailing Address - Country:US
Mailing Address - Phone:702-272-2724
Mailing Address - Fax:702-445-6977
Practice Address - Street 1:7455 W WASHINGTON AVE STE 422
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-4347
Practice Address - Country:US
Practice Address - Phone:702-272-2724
Practice Address - Fax:702-445-6977
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7511207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019768Medicaid
38822Medicare ID - Type Unspecified
NV002019768Medicaid