Paul Charles Anderson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1162 Issued in AK

Practice address

2270 Nistler Rd
Delta Junction, AK 99737

Phone

(907) 895-4274

Fax

(907) 895-4276

NPI assigned

Sep 5, 2006

Last updated

Apr 3, 2012By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Molar Enterprise, Inc.

  dba Timbercrest Dental

  • General Practice Dentistry
  • Delta Junction, AK
  • NPI 1730490996
  NPD (past) Authorized official

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1467554733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 985",
            "city": "DELTA JUNCTION",
            "state": "AK",
            "postal_code": "997370985",
            "telephone_number": "907-895-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 NISTLER RD",
            "city": "DELTA JUNCTION",
            "state": "AK",
            "postal_code": "99737",
            "telephone_number": "907-895-4274",
            "fax_number": "907-895-4276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "PAUL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1527523",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DD08701",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alpha Omega Life Care, Inc.
• Alpha Omega Life Care, Inc.
• Alpha Omega Life Care, Inc.
• Alpha Omega Life Care, Inc.
• Alpha Omega Life Care, Inc.
• Saundra Rae Anderson, D.O.
• Raymond Edgar Andreassen, D.O.
• Arctic Chiropractic Delta
• Arctic Chiropractic Delta
• Arctic Physical Therapy and Rehabilitation Delta Junction LLC

• General Practice Dentistry in Delta Junction, AK
• Providers in Delta Junction, AK by specialty
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.