Jared R Anderson, DDS
Individual provider Active NPI General Practice Dentistry · Ashland, OR
NPI 1124281092 · NPPES record last updated Feb 6, 2014
Key facts
- NPI
- 1124281092
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D8086 (OR)
- Practice address
- 325 A Street
Suite 2
Ashland, OR 97520 - Phone
- (541) 488-5088
- Fax
- (541) 488-5199
- NPI assigned
- Jul 9, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251106002118 | OR | Order and Referring Only - Dentist |
4082104286 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D8086 | OR | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D8086 | OR | Yes |
Addresses
Primary practice location
325 A Street
Suite 2
Ashland, OR 97520
Mailing address
1800 Valley River Dr
Suite 200
Eugene, OR 97401-6714
Phone (541) 301-8861
Other providers in Ashland, OR
- Amirah David Counseling, LLC
- Amy Sloper LPC LLC
- Amy Therrien
- Ancillary Resources
- Carrie Mae Anderson
- Shawnee R Anderson
- Carol Ann Anglesey
- Ethan Anthony Arlt
- Artemis Midwifery
- Sara May Artemisia
All providers in Ashland, OR · General Practice Dentistry in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.