Michael Anderson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4324 Issued in ID

Practice address

2033 E Summersweet Dr
Boise, ID 83716-6695

Phone

(208) 331-0182

Fax

(208) 331-0184

NPI assigned

Aug 11, 2010

Last updated

Aug 11, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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.

• Idaho State University

  • Dentist
  • Boise, ID
  • NPI 1912110164
  NPD (past)

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1609181940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 E SUMMERSWEET DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837166695",
            "telephone_number": "208-331-0182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 E SUMMERSWEET DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837166695",
            "telephone_number": "208-331-0182",
            "fax_number": "208-331-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-11",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry W Anderson, DPM
• Lucille Mae Anderson, OTR/L
• Mandy Anderson, LCSW
• Maria Anderson
• Matthew Anderson, PHARMD
• Nicholas Anderson, LPC
• Noel Anderson, PA-C
• Pamela P Anderson, M.A. COUN., LCPC
• Philip Anderson, DO
• Rachael Anderson, LCPC

• General Practice Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; 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.