Active NPI
John Joseph Anderson, DMD
- Dentist
- Vincennes, IN
National Provider Identifier
1508605718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12014396A
- Practice address
- 608 S Quail Run Rd
Vincennes, IN 47591-6884 - Phone
- (812) 882-1572
- Fax
- (812) 882-4450
- NPI assigned
- May 20, 2024
- Last updated
- May 20, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12014396A | IN | Primary |
Addresses
Primary practice location
608 S Quail Run Rd
Vincennes, IN 47591-6884
Mailing address
608 S Quail Run Rd
Vincennes, IN 47591-6884
Phone (812) 882-1572
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12014396A | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Herman Family Dental LLC | Dentist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Vincennes, IN
- NPI 1811337538
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1508605718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 S QUAIL RUN RD",
"city": "VINCENNES",
"state": "IN",
"postal_code": "475916884",
"telephone_number": "812-882-1572",
"fax_number": "812-882-4450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 S QUAIL RUN RD",
"city": "VINCENNES",
"state": "IN",
"postal_code": "475916884",
"telephone_number": "812-882-1572",
"fax_number": "812-882-4450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JOHN",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-20",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12014396A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vincennes, IN
- Amedco Indiana LLC (Wabash Valley Eye Surgery Center)
- Amedco Indiana LLC (Wabash Valley Eye Center)
- Amedco Indiana LLC (Wabash Valley Eye Center)
- Amedco Indiana LLC (Wabash Valley Eye Center)
- Amedco Indiana LLC (Wabash Valley Eye Surgery Center)
- Kelly R Anderson, DO
- Linda Anderson, LCSW
- Anesthesia Associates, Inc.
- Another Chance Christ Ministries
- Trista Armes, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.