Individual provider Active NPI

Michael Joseph Anderson, DDS

  • General Practice Dentistry
  • Denham Springs, LA
National Provider Identifier
1477558369
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5260 Issued in LA
Practice address
610 North Range Avenue
Denham Springs, LA 70726-2900
Phone
(225) 665-1212
Fax
(225) 664-7404
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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 5260 LA Primary

Addresses

Primary practice location

610 North Range Avenue
Denham Springs, LA 70726-2900

Mailing address

610 North Range Avenue
Denham Springs, LA 70726-2900
Phone (225) 665-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160121002450 LA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1456654664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5620LAMDProfessional Counselor
5260LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Douglas D. Strickland and Associates General Practice Past 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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1477558369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 NORTH RANGE AVENUE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707262900",
            "telephone_number": "225-665-1212",
            "fax_number": "225-664-7404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 NORTH RANGE AVENUE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707262900",
            "telephone_number": "225-665-1212",
            "fax_number": "225-664-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denham Springs, LA

Sources for this page

Verify at the official NPI Registry.