Individual provider Active NPI

William Hart Anderson III, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Great Lakes, IL
National Provider Identifier
1780657221
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
20084 Issued in CA
Practice address
3001 6TH St
Naval Hospital, Dental Directorate
Great Lakes, IL 60088-2833
Phone
(184) 768-8242
Fax
(184) 768-8440
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 20084 CA Primary

Addresses

Primary practice location

3001 6TH St
Naval Hospital, Dental Directorate
Great Lakes, IL 60088-2833

Mailing address

135 W Newbridge LN
Round Lake, IL 60073-5645
Phone (184) 768-8242

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

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780657221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W NEWBRIDGE LN",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600735645",
            "telephone_number": "184-768-8242",
            "fax_number": "184-768-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 6TH ST",
            "address_2": "NAVAL HOSPITAL, DENTAL DIRECTORATE",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882833",
            "telephone_number": "184-768-8242",
            "fax_number": "184-768-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "WILLIAM",
        "middle_name": "HART",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "20084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Lakes, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.