Brad Andersen, D.M.D.
Individual provider Active NPI General Practice Dentistry · Mountain City, TN
NPI 1053761189 · NPPES record last updated Jul 5, 2022
Key facts
- NPI
- 1053761189
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D01443 (OR)
- Practice address
- 144 Calvary LN
Mountain City, TN 37683-4306 - Phone
- (423) 727-0655
- NPI assigned
- Jun 20, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D01443 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MC Dental Services | General Practice | Current | Accepting new patients |
| Hampton Dental Group | General Practice | Current | Accepting new patients |
| Crown Haus, PLLC | General Practice | Current |
Accepting new patients |
Locations
144 Calvary Ln
Mountain City, TN 37683
Phone (423) 218-9729
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D01443 | OR | Yes |
Addresses
Primary practice location
144 Calvary LN
Mountain City, TN 37683-4306
Mailing address
144 Calvary LN
Mountain City, TN 37683-4306
Phone (423) 727-0655
Other providers in Mountain City, TN
- Adams Pharmacy LLC
- Holly Adams
- Samuel B Adams Jr.
- Olubusola Afolayan
- Amy Crosswhite, PLLC
- Courtney Ann Andersen
- Hope Anderson
- Appalachian Emergency Physicians
- Appalachian Medical Equipment Co., Inc.
- Terry L Armstrong Jr.
All providers in Mountain City, TN · General Practice Dentistry in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.