Devin Anderson, D.D.S.

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

46353 Issued in CA

Practice address

11261 Wareham CT
Loma Linda, CA 92354-4875

Phone

(909) 496-1718

Fax

(909) 478-0778

NPI assigned

Jul 11, 2014

Last updated

Jul 11, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Devin Anderson D,D.S.

  • Dental Clinic/Center
  • Loma Linda, CA
  • NPI 1467867580
  NPD (past) Authorized official

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1629484522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11261 WAREHAM CT",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923544875",
            "telephone_number": "909-496-1718",
            "fax_number": "909-478-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11261 WAREHAM CT",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923544875",
            "telephone_number": "909-496-1718",
            "fax_number": "909-478-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DEVIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CA",
            "license": "46353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "520882",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lana S. Anders, RN
• Avery Karyn Erickson Anderson, MS, RN, FNP-C
• Bailey Taylor Anderson, MD, MBA
• Charles Kent Anderson, MD
• Danyon Anderson, MD
• Donald L Anderson, M.D.
• Garth Alan Anderson
• Keith Erik Anderson, RN, NP
• Lindsey Diane Anderson, D.D.S.
• Melvonti Anderson, RN

• Dental Anesthesiology in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Dental Anesthesiology in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; 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.