Active NPI
Robert Scott Anderson, DDS
- General Practice Dentistry
- Salem, SC
National Provider Identifier
1720191968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4549
- Practice address
- 25 Eastern PT
Salem, SC 29676 - Phone
- (864) 719-0079
- Fax
- (864) 719-0079
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- No
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4549 | SC | MD | Physical Therapist |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4549 | SC | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
25 Eastern PT
Salem, SC 29676
Mailing address
25 Eastern PT
Salem, SC 29676
Phone (864) 719-0079
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0608524 | Medicaid | OH |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 14, 2016.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476403200000",
"number": "1720191968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 EASTERN PT",
"city": "SALEM",
"state": "SC",
"postal_code": "29676",
"telephone_number": "864-719-0079",
"fax_number": "864-719-0079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 EASTERN PT",
"city": "SALEM",
"state": "SC",
"postal_code": "29676",
"telephone_number": "864-719-0079",
"fax_number": "864-719-0079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ROBERT",
"middle_name": "SCOTT",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2016-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SC",
"license": "4549",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0608524",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salem, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.