Marilyn Andersen, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DDS100452 Issued in CA

Practice address

Naval Medical Center San Diego
34800 Bob Wilson Drive
San Diego, CA 92134-5000

Phone

(619) 532-7935

NPI assigned

Jul 20, 2016

Sex

Female

Sole proprietor

No

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

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": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1174976690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER SAN DIEGO",
            "address_2": "34800 BOB WILSON DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER SAN DIEGO",
            "address_2": "34800 BOB WILSON DRIVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345000",
            "telephone_number": "619-532-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "MARILYN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS100452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Andersen
• Josefina Legaspi Andersen, RN
• Karie F Andersen, MD
• Kathryn Andersen
• Krystal Andersen
• Rosa Yvonne Andersen, LMFT
• Sarah Andersen
• Stuart James Andersen, M.D.
• William Frederick Andersen
• Anderson Chiropractic & Wellness

• Oral and Maxillofacial Surgery (Dentist) in San Diego, CA
• Providers in San Diego, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; 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.