Active NPI
Jennifer Dooley Anderson, D.M.D.
- Periodontics
- Hayes, VA
National Provider Identifier
1811170202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 0401413732
- Practice address
- 2654 George Washington Memorial Hwy
Hayes, VA 23072-3464 - Phone
- (804) 642-3558
- Fax
- (804) 642-6712
- NPI assigned
- Dec 9, 2007
- Last updated
- Feb 20, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 0401413732 | VA | Primary |
Addresses
Primary practice location
2654 George Washington Memorial Hwy
Hayes, VA 23072-3464
Mailing address
2654 George Washington Memorial Hwy
Hayes, VA 23072-3464
Phone (804) 642-3558
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401413732 | VA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740009600000",
"number": "1811170202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2654 GEORGE WASHINGTON MEMORIAL HWY",
"city": "HAYES",
"state": "VA",
"postal_code": "230723464",
"telephone_number": "804-642-3558",
"fax_number": "804-642-6712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2654 GEORGE WASHINGTON MEMORIAL HWY",
"city": "HAYES",
"state": "VA",
"postal_code": "230723464",
"telephone_number": "804-642-3558",
"fax_number": "804-642-6712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JENNIFER",
"middle_name": "DOOLEY",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-09",
"last_updated": "2025-02-20",
"certification_date": "2025-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "VA",
"license": "0401413732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayes, VA
- Abingdon Volunteer Fire and Rescue, Inc.
- Acorn Behavioral Consulting
- Muhanned A Alhadad, DDS
- American Addiction Treatment Center, Inc (American Addiction Treatment Center-Gloucester)
- Americare Plus, LLC. (AmeriCare Plus - Gloucester /West Point)
- Abiodun Badamosi
- Bay Medical Services Inc.
- Jonh P Bonesteel, DDS
- Susan S Bonner, PA-C
- Anne Elizabeth Braim, OD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.