Robert Anderson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D008607 Issued in AZ

Practice address

3775 Stockton Hill Rd Ste C
Kingman, AZ 86409

Phone

(928) 692-9135

Fax

(928) 692-9408

NPI assigned

Jul 31, 2006

Last updated

Jun 25, 2015By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1124034251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 STOCKTON HILL RD STE C",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-692-9135",
            "fax_number": "928-692-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 STOCKTON HILL RD STE C",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-692-9135",
            "fax_number": "928-692-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3383",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D008607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "779810",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonya Allen I, NP
• Jean Ann Amico
• Amerest Anderson
• Leellen Lou Anderson, LASAC
• Melissa Anderson, PHARMD
• Joanne Kaye Appelhans, ED.S. NCSP
• Edward Jacob Arias, DO
• Arizona CVS Stores, L.L.C. (CVS Pharmacy # 08977)
• Arizona Desert Dermatology and Surgery PC
• Arizona Institure of Medicine & Surgery

• General Practice Dentistry in Kingman, AZ
• Providers in Kingman, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; 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.