Shawn R Anderson, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D008275 Issued in AZ

Practice address

25109 Jefferson Ave
#220
Murrieta, CA 92562-8116

Phone

(951) 514-7377

NPI assigned

Jul 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1770504235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46254 DURANGO DR",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925924232",
            "telephone_number": "951-514-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25109 JEFFERSON AVE",
            "address_2": "#220",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925628116",
            "telephone_number": "951-514-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SHAWN",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D008275",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "57725",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100509660",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James M Anderson, MFT
• James Russell Anderson, M.A., CCC/A
• Jenna Nicole Anderson
• Kevin Anderson, RN
• Mirna Anderson, RN
• Tracey Anderson, FNP
• Vanessa Jean Anderson
• Celina Riad Andonie, MD
• Amanda Andrade
• Andrew Erwteman MD Inc

• Endodontics in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.