Courtney Allison Anderson, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D11673 Issued in MN

Practice address

1410 Madison Ave
Mankato, MN 56001-5440

Phone

(507) 344-8698

Fax

(507) 344-8759

NPI assigned

May 15, 2007

Last updated

Oct 3, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 5, 2023 through Sep 5, 2027

Medicare enrollment (NPD)

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.

• Southeastern Minnesota Oral & Maxillofacial Surgery Associates, PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Rochester, MN
  • NPI 1659492312
  NPD (past)
• Daniel C. Burchfield, DMD Et Al PTR.

  • Oral and Maxillofacial Surgery (Dentist)
  • Hendersonville, TN
  • NPI 1861474694
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759449600000",
    "number": "1568678985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015440",
            "telephone_number": "507-344-8698",
            "fax_number": "507-344-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560015440",
            "telephone_number": "507-344-8698",
            "fax_number": "507-344-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "COURTNEY",
        "middle_name": "ALLISON",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "WI",
            "license": "6669",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D11673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy M Anderson
• Anita K. Anderson
• Bridget Mae Anderson
• Bryce Douglas Anderson, D.C.
• Coriann E Anderson
• Craig H Anderson, MD
• Emma Morgan Anderson
• John Mark Anderson, D.D.S
• Katherine A. Anderson, M.D.
• Kurt Alan Anderson

• Oral and Maxillofacial Surgery (Dentist) in Mankato, MN
• Providers in Mankato, MN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.