Bradley Jon Anderson, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2045 Issued in ND

Practice address

4521 38TH Ave S
Fargo, ND 58104-8507

Phone

(701) 232-1368

Fax

(701) 232-4746

NPI assigned

May 18, 2009

Last updated

May 18, 2009By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Anderson & Breding Dental LLC

  • Dental Clinic/Center
  • Fargo, ND
  • NPI 1215278676
  NPD (past) Authorized official

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242604800000",
    "number": "1174758361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 38TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048507",
            "telephone_number": "701-232-1368",
            "fax_number": "701-232-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4521 38TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048507",
            "telephone_number": "701-232-1368",
            "fax_number": "701-232-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRADLEY",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-18",
        "last_updated": "2009-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Anderson
• Andrea Jean Anderson, RN
• Bethany Ann Anderson
• Bonnie Anderson, NP
• Brad C Anderson, DPM
• Brandan Alan Anderson, D.C.
• Brandi J Anderson
• Brendan Anderson, PHARMD
• Brian D Anderson, LMSW
• Bridget L Anderson, DPT

• General Practice Dentistry in Fargo, ND
• Providers in Fargo, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.