Anderson Family Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

01919692 Issued in IL

Legal business name

ANDERSON FAMILY DENTISTRY

Practice address

810 S. Waukegan Rd.
Suite 106
Lake Forest, IL 60045

Phone

(847) 295-0515

Fax

(847) 234-0048

NPI assigned

Sep 3, 2008

Last updated

Sep 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth R. Anderson Jr., D.D.S.NPI 1992003370

Title

President

Phone

(847) 295-0515

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth R Anderson Jr., D.D.S

  • Dentist
  • Lake Forest, IL
  • NPI 1992003370
  NPD (past) Authorized official
• Rosemary Santoro, D.D.S

  • Dentist
  • Lake Forest, IL
  • NPI 1295268233
  NPD (past)
• Rosemarie Jean Santoro, LCSW

  • Clinical Social Worker
  • Pleasantville, NY
  • NPI 1477887651
  NPD (past)

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1184872137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S. WAUKEGAN RD.",
            "address_2": "SUITE 106",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "60045",
            "telephone_number": "847-295-0515",
            "fax_number": "847-234-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S. WAUKEGAN RD.",
            "address_2": "SUITE 106",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "60045",
            "telephone_number": "847-295-0515",
            "fax_number": "847-234-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-295-0515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "01919692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammed Sami Saleh Alzoubaidi, MBBS,MPH
• American Drug Stores LLC (Osco Drug #3490)
• Sushma Surapaneni Anand, D.O.
• Ancient Healing Oriental Medicine Clinic S.C. (Ancient Healing OMC s.c.)
• Sarah Anne Anderko, D.D.S.
• Christina Kaye Anderson, M.D.
• John P Anderson, PA-C
• Kenneth R Anderson Jr., D.D.S
• Warren Edgar Anderson, M.D.
• John R Andrews, M.D.

• Dentist in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.