Paul Edward Anderson Jr., MD, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN012577 Issued in GA

Practice address

262 S Peachtree Pkwy
Suite 1
Peachtree City, GA 30269-1751

Phone

(770) 302-0101

Fax

(770) 302-0105

NPI assigned

Sep 20, 2006

Last updated

May 18, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Apr 1, 2020 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• David P. Timms., D.D.S.,P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Peachtree City, GA
  • NPI 1720274798
  NPD (past)
• Peachtree Omfs LLC, DBN Peachtree Oral & Facial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Peachtree City, GA
  • NPI 1598544306
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431907200000",
    "number": "1801993605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 S PEACHTREE PKWY",
            "address_2": "SUITE 1",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691751",
            "telephone_number": "770-302-0101",
            "fax_number": "770-302-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 S PEACHTREE PKWY",
            "address_2": "SUITE 1",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691751",
            "telephone_number": "770-302-0101",
            "fax_number": "770-302-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "PAUL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD, DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN012577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce William Anderson, D.D.S.
• Dionne Anderson, DC
• Jaycee Anderson
• John Benjamin Anderson, DPT
• Kimberly Sue Anderson, O.D.
• Andreone Sports & Family Chiropractic
• Christopher P. Andreone, D.C.
• Anesthesia Plus LLC
• Angel Pain Relief Center
• Paula Andrea Angulo

• Oral and Maxillofacial Surgery (Dentist) in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.