Individual provider Active NPI

John H Anderson, DDS

  • Dentist
  • Newport Beach, CA
National Provider Identifier
1649375387
Registry record updated Aug 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38022 Issued in CA
Practice address
2011 Westcliff Dr
Suite 11
Newport Beach, CA 92660-5599
Phone
(949) 722-7722
Fax
(949) 722-7744
NPI assigned
Sep 14, 2006
Last updated
Aug 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38022 CA Primary

Addresses

Primary practice location

2011 Westcliff Dr
Suite 11
Newport Beach, CA 92660-5599

Mailing address

2011 Westcliff Dr
Suite 11
Newport Beach, CA 92660-5599
Phone (949) 722-7722

Other identifiers 1

IdentifierTypeStateIssuer
FHC70520FMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
38022CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1649375387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 WESTCLIFF DR",
            "address_2": "SUITE 11",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605599",
            "telephone_number": "949-722-7722",
            "fax_number": "949-722-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 WESTCLIFF DR",
            "address_2": "SUITE 11",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605599",
            "telephone_number": "949-722-7722",
            "fax_number": "949-722-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "38022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70520F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.