Jacob Matthew Anderson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2014016763 Issued in MO

Practice address

300 SE 2ND St Ste 200
Lees Summit, MO 64063-2759

Phone

(816) 524-6300

NPI assigned

Aug 7, 2014

Last updated

Jan 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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.

• Careswell & Anderson Dental LLC

  • Dental Clinic/Center
  • Lee's Summit, MO
  • NPI 1508476706
  NPD Authorized official
• Kallsnick & Careswell

  • General Practice Dentistry
  • Lee's Summit, MO
  • NPI 1194830992
  NPD (past)

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609545600000",
    "number": "1487063152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SE 2ND ST STE 200",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632759",
            "telephone_number": "816-524-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SE 2ND ST STE 200",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632759",
            "telephone_number": "816-524-6300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "652 Hamilton Rd",
            "address_2": "USA Dental Activity",
            "address_purpose": "LOCATION",
            "city": "Ft. Sill",
            "state": "OK",
            "postal_code": "73503",
            "country_code": "US",
            "telephone_number": "580-442-3905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACOB",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-07",
        "last_updated": "2021-01-02",
        "certification_date": "2021-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2014016763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anchored in Healing, LLC
• Anderson Dental DDS PC
• Bryan Anderson, PHARM D
• Emily Ann Anderson, RN, IBCLC
• Georgiann L Anderson, RN, MSN
• Kaitlyn Ann Anderson, PLPC
• Linda Crismon Anderson, DDS
• Miriam Lorraine Anderson, O.D.
• Sarah Kathryn Anderson, PA-C
• Nicholas Andrews

• Dentist in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2021; 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.