Individual provider Active NPI

Anastasia Lianne Dodson Owens, DDS

  • Dentist
  • Reno, NV
National Provider Identifier
1861684003
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6054 Issued in NV
Practice address
601 W Moana LN
Suite 2
Reno, NV 89509-4955
Phone
(775) 825-8990
Fax
(775) 825-0936
NPI assigned
Aug 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE00011095 WA
Dentist 122300000X 9564 CO
Dentist 122300000X 6054 NV Primary

Addresses

Primary practice location

601 W Moana LN
Suite 2
Reno, NV 89509-4955

Mailing address

601 W Moana LN
Suite 2
Reno, NV 89509-4955
Phone (303) 884-8101

Other names 1

  • Anastasia Lianne Dodson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160125000461 NV Order and Referring Only - DentistPractitioner - Dentist 6406159516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00011095WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1186876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1861684003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W MOANA LN",
            "address_2": "SUITE 2",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094955",
            "telephone_number": "303-884-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W MOANA LN",
            "address_2": "SUITE 2",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094955",
            "telephone_number": "775-825-8990",
            "fax_number": "775-825-0936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "ANASTASIA",
        "middle_name": "LIANNE DODSON",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-12",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00011095",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "9564",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANASTASIA",
            "last_name": "DODSON",
            "middle_name": "LIANNE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.