Individual provider Active NPI

Brian Michael Andersen, D.D.S.

  • General Practice Dentistry
  • Cedar Falls, IA
National Provider Identifier
1740439843
Registry record updated Aug 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08759 Issued in IA
Practice address
3217 Cedar Heights Dr
Cedar Falls, IA 50613-6039
Phone
(319) 277-6921
NPI assigned
Sep 12, 2008
Last updated
Aug 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6295 WI
General Practice Dentistry 1223G0001X 08759 IA Primary

Addresses

Primary practice location

3217 Cedar Heights Dr
Cedar Falls, IA 50613-6039

Mailing address

3217 Cedar Heights Dr
Cedar Falls, IA 50613-6039
Phone (319) 277-6921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20160112002019 IA Order and Referring Only - DentistPractitioner - Dentist 7517269269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08759IAMDGeneral Practice Dentistry
6295WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kimball and Beecher PLLC General Practice Past Accepting new patients
Amy Hartmann Eye Care, LLC PastSince Jul 20, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1221177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280793600000",
    "number": "1740439843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 CEDAR HEIGHTS DR",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506136039",
            "telephone_number": "319-277-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 CEDAR HEIGHTS DR",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506136039",
            "telephone_number": "319-277-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-12",
        "last_updated": "2010-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6295",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Falls, IA

Sources for this page

Verify at the official NPI Registry.