Dr. Thane B. Anderson, DDS, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4812W Issued in WI

Legal business name

DR. THANE B. ANDERSON, DDS, LLC

Practice address

1520 Vernon St
Stoughton, WI 53589-2260

Phone

(608) 873-3213

Fax

(608) 873-7254

NPI assigned

Jul 26, 2007

Organization subpart

No

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

Authorized official

Name

Thane B Anderson, DDS

Title

Owner

Phone

(608) 873-3213

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1245420280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 VERNON ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535892260",
            "telephone_number": "608-873-3213",
            "fax_number": "608-873-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 VERNON ST",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535892260",
            "telephone_number": "608-873-3213",
            "fax_number": "608-873-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. THANE B. ANDERSON, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "THANE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-873-3213",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": "4812W",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dillingham, PA-C
• Brittany Dimaggio, MN, RN, APNP, AGCNS
• Kristin Leigh Docter, APNP
• Leah Bernadette Doughty, PA-C
• Steven Dow, DDS
• Sandra M Draus, APNP
• Mary Lynn Driscoll, PHARMD
• David W Druckenbrod, LCSW
• Jeanne Marie Duncan, PT
• Denise Marie Duranczyk, MS, PT

• Dental Clinic/Center in Stoughton, WI
• Providers in Stoughton, WI by specialty
• Dental Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.