Active NPI
Thomas Warren Anderson, DDS
- Dentist
- Coon Rapids, MN
National Provider Identifier
1760655765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D7054
- Practice address
- 11237 Foley Blvd NW
Coon Rapids, MN 55448-3389 - Phone
- (763) 757-1234
- NPI assigned
- Apr 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D7054 | MN | Primary |
Addresses
Primary practice location
11237 Foley Blvd NW
Coon Rapids, MN 55448-3389
Mailing address
11237 Foley Blvd NW
Coon Rapids, MN 55448-3389
Phone (763) 757-1234
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D7054 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207785600000",
"number": "1760655765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11237 FOLEY BLVD NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554483389",
"telephone_number": "763-757-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11237 FOLEY BLVD NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554483389",
"telephone_number": "763-757-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "THOMAS",
"middle_name": "WARREN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-10",
"last_updated": "2008-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D7054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.