Provider Demographics
NPI:1659266088
Name:BURGESS, HOPE NICOLE (DDS)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:NICOLE
Last Name:BURGESS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 S EDGEWATER CV
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-3919
Mailing Address - Country:US
Mailing Address - Phone:210-540-9857
Mailing Address - Fax:
Practice Address - Street 1:331 W PARRISH LN STE 101
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:UT
Practice Address - Zip Code:84014-1853
Practice Address - Country:US
Practice Address - Phone:801-298-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14224063-9926122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist