Ammon L Anderson, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

08617 Issued in IA

Practice address

2910 Hamilton Blvd
Suite 101
Sioux City, IA 51104-2423

Phone

(712) 255-8017

NPI assigned

May 29, 2009

Last updated

May 29, 2009By 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 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243555200000",
    "number": "1760618110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 HAMILTON BLVD",
            "address_2": "SUITE 101",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511042423",
            "telephone_number": "712-255-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 HAMILTON BLVD",
            "address_2": "SUITE 101",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511042423",
            "telephone_number": "712-255-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "AMMON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-29",
        "last_updated": "2009-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "6543",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WY",
            "license": "1127",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IA",
            "license": "08617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amera SL of Sioux City, LLC (Amera Senior Living)
• American Home Health Care Company
• American Homepatient, Inc.
• American Prosthetics & Orthotics, Inc.
• Richard C Andersen, DO
• Ashley Jean Anderson, PMHNP-BC
• August Anderson, MD
• Courtney Anderson
• Crystal Anderson
• Emily Ranae Anderson, CRNA

• Endodontics in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Endodontics in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.