Active NPI
Philip Anderson, DDS
- Dentist
- Seattle, WA
National Provider Identifier
1811333479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4183
- Practice address
- 6536 50TH Ave NE
Seattle, WA 98115-7737 - Phone
- (206) 522-4568
- NPI assigned
- May 22, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4183 | WA | Primary |
Addresses
Primary practice location
6536 50TH Ave NE
Seattle, WA 98115-7737
Mailing address
6536 50TH Ave NE
Seattle, WA 98115-7737
Phone (206) 522-4568
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160516001669 | WA | Order and Referring Only - Dentist | 8527357482 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4183 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369180800000",
"number": "1811333479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6536 50TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981157737",
"telephone_number": "206-522-4568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6536 50TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981157737",
"telephone_number": "206-522-4568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "PHILIP",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-22",
"last_updated": "2013-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "4183",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; 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.