Spencer James Anderson, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

62797 Issued in CA

Practice address

1116 N Chinowth St
Visalia, CA 93291-7896

Phone

(559) 732-7946

Fax

(559) 732-9621

NPI assigned

Feb 17, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 22, 2016 through Jun 22, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Valley Dental Implant & Oral Surgery Institute II

  • Oral and Maxillofacial Surgery (Dentist)
  • Visalia, CA
  • NPI 1154199404
  NPD Authorized official
• Central Valley Dental Implant

  • Oral and Maxillofacial Surgery (Dentist)
  • Visalia, CA
  • NPI 1467457465
  NPD (past)
• David H. Crane, DDS, Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Hanford, CA
  • NPI 1154326031
  NPD (past)

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

{
    "created_epoch": "1392595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1407270135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 N CHINOWTH ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932917896",
            "telephone_number": "402-350-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 N CHINOWTH ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932917896",
            "telephone_number": "559-732-7946",
            "fax_number": "559-732-9621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 W Lacey Blvd",
            "address_purpose": "LOCATION",
            "city": "Hanford",
            "state": "CA",
            "postal_code": "932304342",
            "country_code": "US",
            "telephone_number": "559-582-9286",
            "fax_number": "559-582-9334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SPENCER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-17",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "62797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marianne Sollosy Anderson, M.D.
• Mary J. Anderson, NP
• Nathan Anderson
• Peggy Anderson
• Richard G Anderson, M.D.
• Amanda Rosa Andrade Dos Santos
• Juan Andrade-Garcia
• Yessenia Monique Andrade-Ortiz
• Alejandro Andrade
• Alexzandrah Timmi Andrade

• Oral and Maxillofacial Surgery (Dentist) in Visalia, CA
• Providers in Visalia, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.