Carol Lynn Anderson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1014 Issued in WY

Practice address

1025 10TH Ave
Clarkfield, MN 56223-1301

Phone

(320) 669-7564

Fax

(320) 669-7564

NPI assigned

Oct 5, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Prairie Sky Dental

  • General Practice Dentistry
  • Gillette, WY
  • NPI 1922437847
  NPD (past) Authorized official
• Open Door Health Center

  • General Practice Dentistry
  • Clarkfield, MN
  • NPI 1245682905
  NPD (past)
• Mountain West Dental

  • Dentist
  • Gillette, WY
  • NPI 1346606654
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1538255385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 10TH AVE",
            "city": "CLARKFIELD",
            "state": "MN",
            "postal_code": "562231301",
            "telephone_number": "320-669-7564",
            "fax_number": "320-669-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 10TH AVE",
            "city": "CLARKFIELD",
            "state": "MN",
            "postal_code": "562231301",
            "telephone_number": "320-669-7564",
            "fax_number": "320-669-7564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Richards Ave",
            "address_purpose": "LOCATION",
            "city": "Gillette",
            "state": "WY",
            "postal_code": "827163630",
            "country_code": "US",
            "telephone_number": "307-685-1111",
            "fax_number": "307-685-0011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CAROL",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112512500",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Peder Bollman, O.D.
• Clarkfield Area Charter School
• Clarkfield Care Center (Clarkfield Ambulance Service)
• Clarkfield Care Center (Clarkfield Home Health Agency)
• Clarkfield Care Center

• General Practice Dentistry in Clarkfield, MN
• Providers in Clarkfield, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.