Matthew Ross Anderson, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DE60944562 Issued in WA

Practice address

14400 NE 20TH Ave Ste 100
Vancouver, WA 98686-1412

Phone

(360) 576-5066

NPI assigned

Oct 2, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Scott W George DMD PLLC

  • Periodontics
  • Vancouver, WA
  • NPI 1073198966

  Endodontics

  NPD

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1073864963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14400 NE 20TH AVE STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861412",
            "telephone_number": "360-576-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14400 NE 20TH AVE STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861412",
            "telephone_number": "360-576-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MATTHEW",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-02",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "8418211-9921",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OR",
            "license": "D11375",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": "8418211-9921",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE60944562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Anderson, RN
• Mackenzie Graham Anderson, DO
• Margaret Jo Anderson, CDA, EFDA
• Margret Lillias Anderson, LCSW
• Mark Anderson, MD
• Melanie Anderson
• Micah Franklin Anderson, NP
• Michele Annette Anderson, RN
• Nashreen Anderson, DO
• Philemon Lynn Anderson, M.D.

• Endodontics in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Endodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.