NPIMap

Organization Active NPI

Jared R. Anderson DDS PC

  • General Practice Dentistry
  • Redmond, OR
National Provider Identifier
1124020920
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D6510C Issued in OR
Legal business name
JARED R. ANDERSON DDS PC
Practice address
774 SW Rimrock Dr
Redmond, OR 97756-1941
Phone
(541) 923-7633
Fax
(541) 923-8733
NPI assigned
Aug 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Authorized official

Name
Dr. Jared R. Anderson, DDS
Title
Owner/Operator
Phone
(541) 923-7633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D6510C OR Primary

Addresses

Primary practice location

774 SW Rimrock Dr
Redmond, OR 97756-1941

Mailing address

774 SW Rimrock Dr
Redmond, OR 97756-1941
Phone (541) 923-7633

National Provider Directory

National Provider Directory
Tax ID family
Jared R Anderson DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1124020920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 SW RIMROCK DR",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561941",
            "telephone_number": "541-923-7633",
            "fax_number": "541-923-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 SW RIMROCK DR",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561941",
            "telephone_number": "541-923-7633",
            "fax_number": "541-923-8733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JARED R. ANDERSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "541-923-7633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6510C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.