Gary Nelson Anderberg, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6247 Issued in MD

Practice address

16105 Frederick Rd
Lisbon, MD 21765

Phone

(410) 489-4900

Fax

(410) 489-4900

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043320997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26140 VIEWLAND DR",
            "city": "DAMASCUS",
            "state": "MD",
            "postal_code": "208721231",
            "telephone_number": "301-253-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16105 FREDERICK RD",
            "city": "LISBON",
            "state": "MD",
            "postal_code": "21765",
            "telephone_number": "410-489-4900",
            "fax_number": "410-489-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERBERG",
        "first_name": "GARY",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "6247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Stuart Maupin, D.D.S., P.A.

• All providers in Lisbon, MD
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.