James Robert Anderson, DMD
Individual provider Active NPI Dentist · Gresham, OR
NPI 1063515260 · NPPES record last updated Dec 29, 2015
Key facts
- NPI
- 1063515260
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D7285 (OR)
- Practice address
- 19059 SE Division St
Gresham, OR 97030-5165 - Phone
- (503) 661-4711
- Fax
- (503) 661-4777
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
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 |
|---|---|---|---|
| D7285 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ritta Karam DMD Ma LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D7285 | OR | Yes |
Addresses
Primary practice location
19059 SE Division St
Gresham, OR 97030-5165
Mailing address
19059 SE Division St
Gresham, OR 97030-5165
Phone (503) 661-4711
Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 29, 2015. 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.