John Authur Anderson, DMD MS

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DN9065 Issued in FL

Practice address

2894 S 8TH St
Suite 3
Fernandina Beach, FL 32034-4462

Phone

(904) 261-0022

Fax

(904) 261-6289

NPI assigned

Oct 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750465761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2894 S 8TH ST",
            "address_2": "SUITE 3",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344462",
            "telephone_number": "904-261-0022",
            "fax_number": "904-261-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2894 S 8TH ST",
            "address_2": "SUITE 3",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344462",
            "telephone_number": "904-261-0022",
            "fax_number": "904-261-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOHN",
        "middle_name": "AUTHUR",
        "name_prefix": "Dr.",
        "credential": "DMD MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN9065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthodontics in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.