Alfred Christian Anderson, DDS
Individual provider Active NPI Endodontics · Fort Bragg, NC
NPI 1073583100 · NPPES record last updated Mar 11, 2026
Key facts
- NPI
- 1073583100
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endodontics 1223E0200X
- License
- 4827090-9926 (UT)
- Practice address
- Dept of the Army, Dental Activity, Stop B
2817 Reilly Rd, MCDS-NA-B
Fort Bragg, NC 28310-0001 - Phone
- (910) 396-5610
- Fax
- (910) 396-7017
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Endodontics
- Education
- Other, 2000
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 299
Salt Lake City, UT 84110
PO Box
Suite 299
Salt Lake City, UT 84110-0299
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260501000969 | UT | Practitioner - Endodontics | 7517435118 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4827090-9926 | UT | MD | Endodontist |
| 4827090-9922 | UT | MD | General Practice Dentistry |
Interoperability endpoints
- aanderson818396@direct.med.utah.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 4827090-9926 | UT | Yes |
| General Practice Dentistry | 1223G0001X | 4827090-9922 | UT |
Addresses
Primary practice location
Dept of the Army, Dental Activity, Stop B
2817 Reilly Rd, MCDS-NA-B
Fort Bragg, NC 28310-0001
Mailing address
Dept of the Army, Dental Activity, Stop B
2817 Reilly Rd, MCDS-NA-B
Fort Bragg, NC 28310-0001
Phone (910) 396-5610
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | aanderson818396@direct.med.utah.edu | Direct | University of Utah |
Other providers in Fort Bragg, NC
- AMC Womack-Ft Bragg
- Dhaval K Amin
- Shelby Ammirati
- Zebediah Amparan
- Elizabeth Andersen
- Jennifer Anderson
- Jessica Grace Anderson
- Lisa Marie Anderson
- Patricia Elizabeth Anderson
- Stephen Anderson
All providers in Fort Bragg, NC · Endodontics in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.