Individual provider Active NPI

Karl Andrew Anderson, DDS

  • General Practice Dentistry
  • Saint Paul, MN
National Provider Identifier
1447340419
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9208 Issued in MN
Practice address
1815 Suburban Ave Ste 200
Saint Paul, MN 55119-4380
Phone
(651) 735-4661
Fax
(651) 735-1910
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9208 MN Primary

Addresses

Primary practice location

1815 Suburban Ave Ste 200
Saint Paul, MN 55119-4380

Mailing address

1815 Suburban Ave Ste 200
Saint Paul, MN 55119-4380
Phone (651) 735-4661

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
9208MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sedation and Implant Denstistry - Dr Anderson and Dr Yang PLLC General Practice PastSince Dec 12, 2021 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447340419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 SUBURBAN AVE STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551194380",
            "telephone_number": "651-735-4661",
            "fax_number": "651-735-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 SUBURBAN AVE STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551194380",
            "telephone_number": "651-735-4661",
            "fax_number": "651-735-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KARL",
        "middle_name": "ANDREW",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "9208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.