Active NPI
Kathleen E Anderson, D.M.D.
- Dentist
- Orlando, FL
National Provider Identifier
1659668762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN 19371
- Practice address
- 950 Lake Baldwin LN
Orlando, FL 32814-6651 - Phone
- (407) 515-8500
- NPI assigned
- Jul 10, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN 19371 | FL | Primary |
Addresses
Primary practice location
950 Lake Baldwin LN
Orlando, FL 32814-6651
Mailing address
1206 Burning Tree LN
Winter Park, FL 32792-5123
Phone (352) 339-0959
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN 19371 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Baldwin Dental of Orlando PLLC | Dentist | Past | Accepting new patients |
| Lake Baldwin Dental PA | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Orlando, FL
- NPI 1114211273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416960000000",
"number": "1659668762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1206 BURNING TREE LN",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327925123",
"telephone_number": "352-339-0959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 LAKE BALDWIN LN",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328146651",
"telephone_number": "407-515-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "KATHLEEN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-10",
"last_updated": "2014-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN 19371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.