Active NPI
Andre Anderson, DDS
- Dentist
- La Vergne, TN
National Provider Identifier
1174019731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10824
- Practice address
- 5295 Murfreesboro Rd
La Vergne, TN 37086-2724 - Phone
- (615) 930-0380
- NPI assigned
- Jul 6, 2018
- Last updated
- Jun 3, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10824 | TN | Primary |
Addresses
Primary practice location
5295 Murfreesboro Rd
La Vergne, TN 37086-2724
Mailing address
5295 Murfreesboro Rd
La Vergne, TN 37086-2724
Phone (615) 930-0380
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10824 | TN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lignum Dentistry, P.C. | Current | Accepting new patients |
Locations
5295 Murfreesboro Rd
La Vergne, TN 37086
Phone (615) 930-0380
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622678400000",
"number": "1174019731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5295 MURFREESBORO RD",
"city": "LA VERGNE",
"state": "TN",
"postal_code": "370862724",
"telephone_number": "615-930-0380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5295 MURFREESBORO RD",
"city": "LA VERGNE",
"state": "TN",
"postal_code": "370862724",
"telephone_number": "615-930-0380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ANDRE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-06",
"last_updated": "2021-06-03",
"certification_date": "2021-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "10824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Vergne, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.