Stacey Francis Anderson, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

H5437 Issued in MN

Practice address

2454 Highway 2
Two Harbors, MN 55616-3000

Phone

(218) 206-4328

NPI assigned

Apr 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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.

• Just Kids Dental Inc

  • Dental Hygienist
  • Two Harbors, MN
  • NPI 1013233873
  Authorized official Same address or phone

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508080615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 HIGHWAY 2",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556163000",
            "telephone_number": "218-206-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2454 HIGHWAY 2",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556163000",
            "telephone_number": "218-206-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "STACEY",
        "middle_name": "FRANCIS",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MN",
            "license": "H5437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN DENTAL HYG",
            "identifier": "DHS 709417500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL UCARE PROVIDER",
            "identifier": "9184066",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Abbott, MSOT, OTR/L
• Agate Bay Assisted Living LLC
• Agate Bay Professionals Chemical Health Services
• Debbie Anne Allert, M.D.
• Bradley James Alm, RN
• Barross Manor, LLC
• Stephanie Bellrichard, PHARMD
• Jason Olai Berg, DDS
• Jacob Thomas Blong, DPT
• Blustin Optical Center Dba Derin J Van Loon, O.D.

• Dental Hygienist in Two Harbors, MN
• Providers in Two Harbors, MN by specialty
• Dental Hygienist in Minnesota

• 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.