Organization Active NPI

Richard Anderson DDS

  • General Practice Dentistry
  • Santa Rosa, CA
National Provider Identifier
1700029303
Registry record updated Apr 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58008 Issued in CA
Legal business name
RICHARD ANDERSON DDS
Practice address
90 Doctors Park Drive
Santa Rosa, CA 95405-9998
Phone
(707) 545-0944
Fax
(707) 545-0947
NPI assigned
Apr 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2009

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

Authorized official

Name
Dr. Richard Paul Anderson, D.D.S.
Title
President
Phone
(707) 545-0944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 58008 CA Primary

Addresses

Primary practice location

90 Doctors Park Drive
Santa Rosa, CA 95405-9998

Mailing address

90 A Doctors Park Drive
Santa Rosa, CA 95405-9998
Phone (707) 545-0944

Other identifiers 1

IdentifierTypeStateIssuer
1265558605OtherCANPPES

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239580800000",
    "number": "1700029303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 A DOCTORS PARK DRIVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954059998",
            "telephone_number": "707-545-0944",
            "fax_number": "707-545-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 DOCTORS PARK DRIVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954059998",
            "telephone_number": "707-545-0944",
            "fax_number": "707-545-0947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD ANDERSON DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2009-04-13",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-545-0944",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1265558605",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; 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.