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Export Provider Record NPI 1053463109
Richard L BurgessDDS
Active
NPI Number1053463109
NPI TypeNPI-1 Individual
SpecialtyDentist, General Practice
Provider Details
NPI1053463109
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2007-01-17
Last Updated2021-05-25
Mailing AddressPo Box 701047
San Antonio, TX 78270-1047
United States
Phone: (210) 532-5461
📍 View Map
Primary Practice Address4721 Pecan Valley Dr
San Antonio, TX 78223-1630
United States
Phone: (210) 532-5461
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDTX13310
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No122300000X – DentistTX13310
Yes1223G0001X – Dentist, General PracticeTX13310
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About NPI 1053463109

Richard L Burgess DDS is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1053463109. The primary specialty listed is Dentist, General Practice. The provider is located in San Antonio, TX. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-01-17. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1053463109?

NPI 1053463109 belongs to Richard L Burgess DDS, a Dentist, General Practice in San Antonio, TX. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1053463109 active?

The current status of NPI 1053463109 in the NPPES registry is Active. The record was last updated on 2021-05-25.

What specialty is NPI 1053463109?

NPI 1053463109 is classified under the taxonomy Dentist, General Practice. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1053463109?

You can verify NPI 1053463109 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1053463109?

The primary practice address on file for NPI 1053463109 is 4721 Pecan Valley Dr, San Antonio, TX 78223-1630. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1053463109 issued?

NPI 1053463109 was first issued (enumerated) on 2007-01-17. The NPPES record was last updated on 2021-05-25.

Practice Location Map

Richard L Burgess is located at 4721 Pecan Valley Dr, San Antonio, TX. Use the map below to find directions or verify the practice location.

📍 4721 Pecan Valley Dr, San Antonio, TX 78223-1630  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Richard L Burgess. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1053463109. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Dentist13310TX
Dentist, General Practice13310TX
Data Verified from CMS NPPES Last synced: 2026-06-15 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162