Thomas Martin Anderson Jr., DDS

Individual provider Active NPI General Practice Dentistry · Clemmons, NC

NPI 1104853654 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104853654
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
6542 (NC)
Practice address
2245 Lewisville Clemmons Rd
Suite B
Clemmons, NC 27012-7464
Phone
(336) 766-3377
Fax
(336) 766-3661
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas M Anderson DDS PA Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6542 NC Yes

Addresses

Primary practice location

2245 Lewisville Clemmons Rd
Suite B
Clemmons, NC 27012-7464

Mailing address

2245 Lewisville Clemmons Road
Suite B
Clemmons, NC 27012
Phone (336) 766-3377

Other identifiers

IdentifierTypeStateIssuer
90044OtherNCBCBS
979466OtherNCUNITED CONCORDIA

Other providers in Clemmons, NC

All providers in Clemmons, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.