Thane B Anderson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4812W Issued in WI

Practice address

1520 Vernon St
Stoughton, WI 53589-2260

Phone

(608) 873-3213

Fax

(608) 873-7254

NPI assigned

Aug 10, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Dr. Thane B. Anderson, DDS, LLC

  • Dental Clinic/Center
  • Stoughton, WI
  • NPI 1245420280
  Authorized official Same address or phone

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104837921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 VERNON ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535892260",
            "telephone_number": "608-873-3213",
            "fax_number": "608-873-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 VERNON ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535892260",
            "telephone_number": "608-873-3213",
            "fax_number": "608-873-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "THANE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "4812W",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Elizabeth Adams, OD
• Guirish A Agni, MD
• Richard A Albright, D.D.S.
• Mary Allen, LCSW
• Paul R Allen, RN, RCS
• Thor Jason Anderson, DDS
• Aryv of Arkansas LLC
• Aryv of Idaho LLC
• Aryv of Indiana LLC
• Aryv of Oklahoma LLC

• General Practice Dentistry in Stoughton, WI
• Providers in Stoughton, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.