Anderson Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

MS2164-85 Issued in MS

Legal business name

ANDERSON DENTAL, LLC

Practice address

514-D East Woodrow Wilson Dr.
Jackson, MS 39216-4538

Phone

(601) 366-1112

Fax

(601) 366-6092

NPI assigned

Mar 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Leon Anderson Jr., D.M.D.

Title

Owner

Phone

(601) 366-1112

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013033851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 11277",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392831277",
            "telephone_number": "601-366-1112",
            "fax_number": "601-366-6092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514-D EAST WOODROW WILSON DR.",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164538",
            "telephone_number": "601-366-1112",
            "fax_number": "601-366-6092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "LEON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-366-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "MS2164-85",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashish Anand, M.D
• Gaurav Anand
• Indu Kathuria Anand
• Vinod Kumar Anand, MD
• Michael Alexander Anders
• Tiffany C Anderson-Washington, LPC, DPC
• Andrea Hayden Anderson
• Andrew Joseph Anderson Jr., M.D.
• Andrianna J. Anderson, MD
• Bailey Anderson

• General Practice Dentistry in Jackson, MS
• Providers in Jackson, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.