Anderson Dental Associates IV

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ANDERSON DENTAL ASSOCIATES IV

Doing business as

RenovaSmiles

Practice address

12721 Darby Brook CT Ste 101
Woodbridge, VA 22192-2408

Phone

(703) 520-1980

NPI assigned

May 23, 2024

Last updated

May 23, 2024By 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

Joshua Anderson, DDS

Title

Owner

Phone

(860) 817-2787

Specialties & licenses 1

Addresses

Other names 1

• RenovaSmiles Doing business as

Locations

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1205675675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12721 DARBY BROOK CT STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922408",
            "telephone_number": "703-520-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12721 DARBY BROOK CT STE 101",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922408",
            "telephone_number": "703-520-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON DENTAL ASSOCIATES IV",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-817-2787",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RenovaSmiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne Amsler
• Amz Collections LLC
• An Added Touch Salon & Barber LLC (An Added Touch Salon)
• Anderson Dental Associates II PLLC (RenovaSmiles Woodbridge)
• Anderson Dental Associates III, PLLC
• Anderson-Khimani Center for Early Intervention and Autism Services
• Charles Anderson, PH.D.
• Eliana Lourdes Anderson, DDS
• Maralize Hester Anderson, CCC-SLP
• Melissa Beth Anderson, LCSW, LSATP

• General Practice Dentistry in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.