Provider Demographics
NPI:1619184496
Name:BENNETT-BURTON, TINA (DC)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:BENNETT-BURTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:TINA
Other - Middle Name:MICHELLE
Other - Last Name:ARIKAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2700 VALLEY VIEW LN
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-4925
Mailing Address - Country:US
Mailing Address - Phone:214-718-7832
Mailing Address - Fax:855-831-9205
Practice Address - Street 1:2700 VALLEY VIEW LN
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-4925
Practice Address - Country:US
Practice Address - Phone:214-718-7832
Practice Address - Fax:855-831-9205
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10635111N00000X
TXDC-10635111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3808651-01Medicaid
TX629006AR6EOtherMEDICARE