Provider Demographics
NPI:1508142811
Name:JAMES K BURNHAM DDS, MS, PLLC
Entity Type:Organization
Organization Name:JAMES K BURNHAM DDS, MS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:BURNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:509-886-0664
Mailing Address - Street 1:101 11TH ST NE
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4481
Mailing Address - Country:US
Mailing Address - Phone:509-886-0664
Mailing Address - Fax:509-886-9604
Practice Address - Street 1:101 11TH ST NE
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-4481
Practice Address - Country:US
Practice Address - Phone:509-886-0664
Practice Address - Fax:509-886-9604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00009046261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental