Thomas M Anderson DDS PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

THOMAS M ANDERSON DDS PA

Practice address

2245 Lewisville Clemmons Road Suite B
Clemmons, NC 27012

Phone

(336) 766-3377

Fax

(336) 766-3661

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Martin Anderson Jr.NPI 1104853654

Title

Owner

Phone

(336) 766-3377

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Thomas Martin Anderson Jr., DDS

  • General Practice Dentistry
  • Clemmons, NC
  • NPI 1104853654
  NPD (past) Authorized official
• Taylor Hewett, DMD

  • Dentist
  • Clemmons, NC
  • NPI 1851829576
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700970878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 LEWISVILLE CLEMMONS ROAD SUITE B",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "27012",
            "telephone_number": "336-766-3377",
            "fax_number": "336-766-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 LEWISVILLE CLEMMONS ROAD SUITE B",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "27012",
            "telephone_number": "336-766-3377",
            "fax_number": "336-766-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS M ANDERSON DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-766-3377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "90044",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• The Ivy at Clemmons LLC
• The Little Speech House, PLLC
• Shaozhou Ken Tian, M.D.
• Gina Toscano
• Town Center Vision Optometrists P.a.
• Donna C Trainer
• Triad Nurse Concierge PLLC

• All providers in Clemmons, NC
• Dental Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.