Lisa Anderson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1630 Issued in WY

Practice address

945 W Broadway Ave Apt 201
Jackson, WY 83001-8217

Phone

(307) 734-5200

NPI assigned

Jun 28, 2016

Last updated

Jun 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Alpine Denitstry

  • Dental Clinic/Center
  • Jackson, WY
  • NPI 1619503349
  NPD

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1659722940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 W BROADWAY AVE APT 201",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018217",
            "telephone_number": "307-734-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 W BROADWAY AVE APT 201",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018217",
            "telephone_number": "307-734-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WY",
            "license": "1630",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "D1109",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer R Almond, PA-C
• Alpenglow Counseling Services, LLC
• Alpine Denitstry
• Jan Marie Altman, MA
• Berit L Amundson, MD
• Scot Thomas Anderson, D.C.
• Julia Marie Andracki, OTR
• Donna J. Andrus, M.S.
• Anesthesia Services of Jacksonhole, P.C.
• Angus Goetz DO PC

• Dentist in Jackson, WY
• Providers in Jackson, WY by specialty
• Dentist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.