Mykel Anderson, DMD, MPH, MBA

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

6978 Issued in NV

Practice address

256 E Lake Mead Pkwy
Henderson, NV 89015-6440

Phone

(702) 703-5410

NPI assigned

Sep 14, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

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 and National Provider Directory roles.

• Jr Dental

  • General Practice Dentistry
  • Henderson, NV
  • NPI 1609701358

  Orthodontics and Dentofacial Orthopedics

  NPD (past)

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1609481928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 KELSO DUNES AVE APT 315",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147826",
            "telephone_number": "951-313-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 E LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890156440",
            "telephone_number": "702-703-5410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1485 Graeber St Bldg 2300",
            "address_purpose": "LOCATION",
            "city": "March Air Reserve Base",
            "state": "CA",
            "postal_code": "925181717",
            "country_code": "US",
            "telephone_number": "951-655-6270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MYKEL",
        "credential": "DMD, MPH, MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "DDS104743",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NV",
            "license": "6978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "sunrisemountaindentalandorthodontics.com",
            "affiliation": "N",
            "address_1": "256 E Lake Mead Pkwy",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890156440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.sunrisemountaindentalandorthodontics.com",
            "affiliation": "N",
            "address_1": "256 E Lake Mead Pkwy",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890156440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.sunrisemountaindentalandorthodontics.com",
            "affiliation": "N",
            "address_1": "256 E Lake Mead Pkwy",
            "city": "Henderson",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890156440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dr.mykelanderson@gmail.com",
            "affiliation": "N",
            "address_1": "1485 Graeber St Bldg 2300",
            "city": "March Air Reserve Base",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925181717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Leah Michelle Anderson, FNP
• Leshauna Jeannine Anderson
• Matthew Cyle Anderson, MS,OTR/L
• Melissa Sue Anderson, P.T.
• Michael J Anderson, MD
• Nicquita Anderson
• Seamus Anderson
• Susan Anderson, FNP
• Natalie A Anderton, DPT
• Darece Andi

• Orthodontics and Dentofacial Orthopedics Dentistry in Henderson, NV
• Providers in Henderson, NV by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.