Charles Anderson, D.D.S.
Individual provider Active NPI Dentist · Franklin, WI
NPI 1104020015 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104020015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 5707-015 (WI)
- Practice address
- 7218 S 76TH St
Franklin, WI 53132-9041 - Phone
- (414) 425-2900
- Fax
- (414) 425-2901
- NPI assigned
- Jun 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|
| 5707-015 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert J. Schweitzer D.D.S.,S.C. | Past | Accepting new patients | |
| Charles C. Anderson D.D.S. S.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5707-015 | WI | Yes |
Addresses
Primary practice location
7218 S 76TH St
Franklin, WI 53132-9041
Mailing address
4217 W Tumble Creek CT
Franklin, WI 53132-9499
Phone (414) 858-9935
Other providers in Franklin, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.