Jeremy Michael Anderson, D.D.S.
Individual provider Active NPI General Practice Dentistry · Victor, MT
NPI 1730346362 · NPPES record last updated Jul 3, 2008
Key facts
- NPI
- 1730346362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2307 (MT)
- Practice address
- 2412 Meridian Rd
Victor, MT 59875 - Phone
- (406) 642-3771
- Fax
- (406) 642-3646
- NPI assigned
- May 21, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161205001521 | MT | Order and Referring Only - Dentist |
5294015483 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anderson Dental, P.C. | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2307 | MT | Yes |
Addresses
Primary practice location
2412 Meridian Rd
Victor, MT 59875
Mailing address
104 Snowberry St
Hamilton, MT 59840-3629
Phone (406) 375-5261
Other providers in Victor, MT
- Joy Clark Akin
- Maureen J Allsop
- Anderson Dental, P.C.
- Angels in Guard LLC
- Annie Bernauer LCSW LLC
- Christiana Bee
- Annie Bernauer
- Rebecca J Conroy
All providers in Victor, MT · General Practice Dentistry in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.