Individual provider Active NPI

Denette Allise Anderson, D.D.S.

  • Dentist
  • Long Beach, CA
National Provider Identifier
1245212125
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36884 Issued in CA
Practice address
1299 E Wardlow Rd
Long Beach, CA 90807-4832
Phone
(562) 426-0423
Fax
(562) 427-4253
NPI assigned
Nov 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36884 CA Primary

Addresses

Primary practice location

1299 E Wardlow Rd
Long Beach, CA 90807-4832

Mailing address

1299 E Wardlow Rd
Long Beach, CA 90807-4832
Phone (562) 426-0423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20160520000683 CA Order and Referring Only - DentistPractitioner - Dentist 6608165253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36884CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245212125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1299 E WARDLOW RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074832",
            "telephone_number": "562-426-0423",
            "fax_number": "562-427-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 E WARDLOW RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074832",
            "telephone_number": "562-426-0423",
            "fax_number": "562-427-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DENETTE",
        "middle_name": "ALLISE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "36884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.