Nicole Marie Anderson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D14771 Issued in MN

Practice address

411 Main St W
Cannon Falls, MN 55009-2074

Phone

(507) 263-2411

NPI assigned

Jun 15, 2022

Last updated

Jul 12, 2022By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Anderson Dentistry PLLC

  • Dental Clinic/Center
  • Cannon Falls, MN
  • NPI 1811687353
  NPD Authorized official

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1588394118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30400 71ST AVENUE WAY",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550094010",
            "telephone_number": "507-291-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 MAIN ST W",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550092074",
            "telephone_number": "507-263-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D14771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anderson Dentistry PLLC
• Angels Care & Rehabilitation Center, LLC (Angels Care Center)
• Madasyn Austin, M.S. CCC-SLP
• Linda Barrett
• Curtis John Beissel
• Sylvia Marie Belford, PHARMD

• Dentist in Cannon Falls, MN
• Providers in Cannon Falls, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.