Active NPI
Mark Steven Anderson
- Dentist
- Cathedral City, CA
National Provider Identifier
1245606060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 64983
- Practice address
- 68905 Vista Chino
Cathedral City, CA 92234-4866 - Phone
- (951) 444-8805
- NPI assigned
- Aug 16, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 64983 | CA | Primary |
Addresses
Primary practice location
68905 Vista Chino
Cathedral City, CA 92234-4866
Mailing address
68905 Vista Chino
Cathedral City, CA 92234-4866
Phone (951) 444-8805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64983 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439683200000",
"number": "1245606060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68905 VISTA CHINO",
"city": "CATHEDRAL CITY",
"state": "CA",
"postal_code": "922344866",
"telephone_number": "951-444-8805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68905 VISTA CHINO",
"city": "CATHEDRAL CITY",
"state": "CA",
"postal_code": "922344866",
"telephone_number": "951-444-8805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "MARK",
"middle_name": "STEVEN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-16",
"last_updated": "2015-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "64983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cathedral City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.