Douglas Taylor Anderson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019018954 Issued in IL

Practice address

552 S Washington St
Suite 220
Naperville, IL 60540-6658

Phone

(630) 357-2525

NPI assigned

Mar 11, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1245400738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 S WASHINGTON ST",
            "address_2": "SUITE 220",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406670",
            "telephone_number": "630-357-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 S WASHINGTON ST",
            "address_2": "SUITE 220",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406658",
            "telephone_number": "630-357-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DOUGLAS",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019018954",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "IL",
            "license": "019018954",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amy Lee Anderson, RPH
• Diann Anderson, LCPC
• Elise Anderson
• Hannah Anderson
• Kaitlyn Anderson, M.A., L.P.C.
• Kristina Anderson, LCSW
• Linda A Anderson

• Dentist in Naperville, IL
• Providers in Naperville, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.