Bruce William Anderson, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

8245 Issued in MN

Practice address

2725 Fox Farm Rd
Worthington, MN 56187-3040

Phone

(507) 372-2869

NPI assigned

Nov 14, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 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": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1124663067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 FOX FARM RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561873040",
            "telephone_number": "507-372-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 FOX FARM RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561873040",
            "telephone_number": "507-372-2869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRUCE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "8245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Mail",
            "affiliation": "N",
            "endpointDescription": "Mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Mail",
            "address_1": "2725 Fox Farm Rd",
            "city": "Worthington",
            "state": "MN",
            "country_code": "US",
            "postal_code": "561873040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara Lynn Adkins, LICSW
• Michael David Ahlers, PHARMD
• Akram Ahmed Ibrahim Ahmed, M.D.
• Joseph J Anderson, PHARMD
• Maria Kathryn Anderson, LMFT
• Applewhite Dental Minnesota, P.C. (AppleWhite Dental Partners of Worthington)
• Mary Elizabeth Arntz, PMHNP
• Barbara Asare-Afriyie, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Worthington, MN
• Providers in Worthington, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.