Tammy L Anderson, DDS
Individual provider Active NPI Dentist · Perham, MN
NPI 1104029347 · NPPES record last updated Jul 15, 2024
Key facts
- NPI
- 1104029347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D12405 (MN)
- Practice address
- 918 Market St
PO Box 328
Perham, MN 56573 - Phone
- (218) 346-7186
- Fax
- (218) 346-7182
- NPI assigned
- Jun 6, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| D12405 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Battle Lake Family Dentistry | Current | Accepting new patients | |
| Mills Family Dentistry PA | Current | Accepting new patients | |
| Perham Family Dentistry | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D12405 | MN | |
| Dentist | 122300000X | D12405 | MN | Yes |
Addresses
Primary practice location
918 Market St
PO Box 328
Perham, MN 56573
Mailing address
918 Market St
PO Box 328
Perham, MN 56573
Phone (218) 346-7186
Other names
- Tammy L Sturdevant
Other providers in Perham, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2024. 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.