Karen Shelby Anderson, DMD

Individual provider Active NPI General Practice Dentistry · Manchester, NH

NPI 1528298650 · NPPES record last updated Nov 27, 2013

Key facts

NPI
1528298650
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2550 (NH)
Practice address
718 Smyth Rd
Vamc
Manchester, NH 03104
Phone
(603) 624-4366
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20140220001548 NH Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
1052541901

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2550NHMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2550 NH Yes

Addresses

Primary practice location

718 Smyth Rd
Vamc
Manchester, NH 03104

Mailing address

718 Smyth Rd
Vamc
Manchester, NH 03104
Phone (603) 624-4366

Other providers in Manchester, NH

All providers in Manchester, NH · General Practice Dentistry in New Hampshire

Sources for this page

Verify at the official NPI Registry.