Provider Demographics
NPI:1356455513
Name:BURNE, JAMES L JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:BURNE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CENTRAL AVE
Mailing Address - Street 2:APT 714
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-5737
Mailing Address - Country:US
Mailing Address - Phone:570-885-0481
Mailing Address - Fax:
Practice Address - Street 1:5425 FRUITVILLE RD
Practice Address - Street 2:SUITE 16
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6418
Practice Address - Country:US
Practice Address - Phone:941-343-9777
Practice Address - Fax:941-343-0184
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO16349L1223G0001X
FLDN21030122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice