Paul V Anderson DDS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9579 Issued in OR

Legal business name

PAUL V ANDERSON DDS LLC

Doing business as

Anderson Dental

Practice address

2900 NW Vine St
Suite L
Grants Pass, OR 97526-8411

Phone

(541) 471-1990

Fax

(541) 471-0325

NPI assigned

Sep 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Paul Vernon Anderson, D.D.SNPI 1336436146

Title

Owner

Phone

(541) 471-1990

Specialties & licenses 1

Addresses

Other names 1

• Anderson Dental Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul V Anderson, D.D.S.

  • General Practice Dentistry
  • Midland, MI
  • NPI 1336436146
  NPD (past) Authorized official
• Forest F Rea, DDS

  • Dentist
  • Grants Pass, OR
  • NPI 1760482616
  NPD (past)

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

{
    "created_epoch": "1316822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316822400000",
    "number": "1619250792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 NW VINE ST",
            "address_2": "SUITE L",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975268411",
            "telephone_number": "541-471-1990",
            "fax_number": "541-471-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 NW VINE ST",
            "address_2": "SUITE L",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975268411",
            "telephone_number": "541-471-1990",
            "fax_number": "541-471-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL V ANDERSON DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-24",
        "last_updated": "2011-09-24",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "VERNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-471-1990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peter Darrell Pastrell, D.M.D.
• Christopher David Patchett
• Heenaben Patel, PHARMD
• Pratima Pathania
• Teasha Brianne Patterson, QMHA
• Joseph G Peaden, LMT
• Deanna Peck
• Heather Peck
• Leigh Anna Peden
• Pediatric TLC PC

• General Practice Dentistry in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2011; 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.