Richard J Anderson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

MN8788 Issued in MN

Practice address

3922 W 50TH St
Edina, MN 55424-1255

Phone

(952) 926-0284

Fax

(952) 926-8723

NPI assigned

Jun 23, 2005

Last updated

Feb 19, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Dr Richard J Anderson DDS PA

  dba Anderson Dentalcare

  • General Practice Dentistry
  • Edina, MN
  • NPI 1548926876
  NPD Authorized official

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1861498933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3922 W 50TH ST",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241255",
            "telephone_number": "952-926-0284",
            "fax_number": "952-926-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3922 W 50TH ST",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241255",
            "telephone_number": "952-926-0284",
            "fax_number": "952-926-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "MN8788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00370AN",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Lynn Anderson, MASSAGE THERAPIST
• Kristie J Anderson, FNP
• Madisyn E Anderson, OTR/L
• Mark Omar Anderson, M.S.
• Michael Joseph Anderson, MD
• Stephanie Leigh Anderson, MD
• Susan E Anderson, OTR/L, CHT
• Tiffany M. Anderson, MA
• Zachary K Anderson, D.O.
• Andrea Burckhard DC PA

• General Practice Dentistry in Edina, MN
• Providers in Edina, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.