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QHSA DBA DR. BRADLEY J BURKET DMD MD NPI 1538579727


NPI Information

NPI: 1538579727
Provider Name: QHSA DBA DR. BRADLEY J BURKET DMD, MD

Doing Business As: DR. BRALDEY J BURKET DMD, MD

Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
2195 NE PROFESSIONAL CT STE 1
BEND, OR
ZIP 97701
Phone: (541) 322-9396
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QHSA DBA DR. BRADLEY J BURKET DMD, MD is a preferred provider organization in Bend, OR. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. QHSA DBA DR. BRADLEY J BURKET DMD, MD NPI is 1538579727. The provider is registered as an organization entity type.
The provider Is Doing Business As Dr. Braldey J Burket Dmd, Md.

The provider's business location address is:

2195 NE PROFESSIONAL CT STE 1
BEND, OR
ZIP 97701-028
Phone: (541) 322-9396
Fax: (541) 322-9398

The provider's authorized official is Misty Boughton .
The authorized official title is Office Manager and has the following contact phone number (541) 322-0376.

The enumeration date for this NPI number is 4/28/2014 and was last updated on 4/28/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305R00000XPreferred Provider OrganizationMD19055OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000BLBYFMEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.