Provider Demographics
NPI:1730231721
Name:CLAIBORNE, BURGIN E (DDS)
Entity type:Individual
Prefix:
First Name:BURGIN
Middle Name:E
Last Name:CLAIBORNE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4561 MILLBRANCH
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38116
Mailing Address - Country:US
Mailing Address - Phone:901-396-5700
Mailing Address - Fax:901-396-3100
Practice Address - Street 1:4561 MILLBRANCH
Practice Address - Street 2:SUITE 1
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38116
Practice Address - Country:US
Practice Address - Phone:901-396-5700
Practice Address - Fax:901-396-3100
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS17961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice