Douglas Anderson, DDS
Individual provider Active NPI General Practice Dentistry · Greendale, WI
NPI 1821291006 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1821291006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6109 (WI)
- Practice address
- 5200 S 76TH St
Greendale, WI 53129-1116 - Phone
- (414) 423-1540
- NPI assigned
- Jun 6, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6109 | WI | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6109 | WI | Yes |
Addresses
Primary practice location
5200 S 76TH St
Greendale, WI 53129-1116
Mailing address
7216 W Beloit Rd
West Allis, WI 53219-1963
Other providers in Greendale, WI
- Morgan Allen
- Saed Alroweisi
- Mohsin Altaf
- Timothy James Alters
- America'S Best Contacts & Eyeglasses
- Robert William Anderson
- Dyan C Badora
- Rosa M Barbeito
- Kim Barna
- Angela Beaudoin
All providers in Greendale, WI · General Practice Dentistry in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.