Provider Demographics
NPI:1619320710
Name:AMRIT K. BURN, DDS, MSD, PLLC
Entity Type:Organization
Organization Name:AMRIT K. BURN, DDS, MSD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST - OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMRIT
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:BURN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:206-362-5911
Mailing Address - Street 1:11066 5TH AVE NE STE 207
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6156
Mailing Address - Country:US
Mailing Address - Phone:206-362-5911
Mailing Address - Fax:206-577-4519
Practice Address - Street 1:11066 5TH AVE NE STE 207
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6156
Practice Address - Country:US
Practice Address - Phone:206-362-5911
Practice Address - Fax:206-577-4519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA110581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1366622706OtherINDIVIDUAL NPI