Jimmie Scott Anderson – General Practice Dentistry

Key facts

NPI: 1154447340
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 6793 (NC)
Practice address: 1819 E Innes St Ste 2
Salisbury, NC 28146-6030
Phone: (704) 636-3611
Fax: (704) 636-3694
NPI assigned: Mar 21, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

Jimmie & Luanne Anderson, DDS, PA General Practice Dentistry · Salisbury, NC · NPI 1043363799

NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Jimmie & Luanne Anderson, DDS, PA	General Practice	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	6793	NC	Yes

Addresses

Primary practice location

1819 E Innes St Ste 2
Salisbury, NC 28146-6030

Mailing address

1819 E Innes St Ste 2
Salisbury, NC 28146-6030
Phone (704) 636-3611

Other identifiers

Identifier	Type	State	Issuer
1895938	Other	NC	UNITED CONCORDIA
81058849	Other	NC	BCBS OF ALABAMA
4074378	Other	NC	BCBS OF TENNESSEE
899011E	Medicaid	NC

Other providers in Salisbury, NC

All providers in Salisbury, NC · General Practice Dentistry in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.