Individual provider Active NPI

Lawrence Brown Anderson II, DMD

  • Dentist
  • Bethesda, MD
National Provider Identifier
1376165373
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEN.00204368 Issued in CO
Practice address
4650 Taylor Road
BLDG 17, 3Rd Floor Room 3140
Bethesda, MD 20889
Phone
(719) 789-5015
NPI assigned
May 12, 2020
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00204368 CO Primary

Addresses

Primary practice location

4650 Taylor Road
BLDG 17, 3Rd Floor Room 3140
Bethesda, MD 20889

Mailing address

5608 Greentree Rd
Bethesda, MD 20817-3550
Phone (719) 789-5015

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

LicenseStateTypeSpecialty
DEN.00204368COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1376165373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5608 GREENTREE RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208173550",
            "telephone_number": "719-789-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 TAYLOR ROAD",
            "address_2": "BLDG 17, 3RD FLOOR ROOM 3140",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20889",
            "telephone_number": "719-789-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LAWRENCE",
        "middle_name": "BROWN",
        "name_suffix": "II",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-12",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00204368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.