Kristen Ashley Anderson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN29443 Issued in FL

Practice address

5995 S Pointe Blvd Ste 109
Fort Myers, FL 33919-3273

Phone

(239) 286-9988

Fax

(239) 737-2869

NPI assigned

Aug 12, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Nicklaus Children'S Hospital

  • Student in an Organized Health Care Education/Training Program
  • Doral, FL
  • NPI 1205648102
  NPD (past)

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1114758117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 S POINTE BLVD STE 109",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193273",
            "telephone_number": "239-286-9988",
            "fax_number": "239-737-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 S POINTE BLVD STE 109",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193273",
            "telephone_number": "239-286-9988",
            "fax_number": "239-737-2869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 NW 107th Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Doral",
            "state": "FL",
            "postal_code": "331784377",
            "country_code": "US",
            "telephone_number": "305-418-7771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KRISTEN",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "DN29443",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN29443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Willis Anderson, RN
• Joseph Anderson, M.D.
• Judith Annette Anderson, LMHC
• Katie Rose Anderson, APRN
• Kimberly M Anderson, LCSW
• Lindsay Elizabeth Anderson
• Noelle Anderson, PA
• Robin Anderson, COTA
• Teresa Lynne Anderson
• Jennifer E Andoscia, BCBA-D

• General Practice Dentistry in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.