Individual provider Active NPI

Lance E. Anderson, DMD

  • General Practice Dentistry
  • Lovell, WY
National Provider Identifier
1871857334
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1305 Issued in WY
Practice address
240 E Main St
Lovell, WY 82431-2102
Phone
(307) 548-7654
Fax
(307) 333-0345
NPI assigned
Jun 29, 2012
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1305 WY Primary

Addresses

Primary practice location

240 E Main St
Lovell, WY 82431-2102

Mailing address

2019 William St
Grand Island, NE 68801-7432
Phone (307) 751-0925

Other practice location 1

337 Greybull Ave
Greybull, WY 82426-2049
Phone (307) 765-4654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1305WYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Greybull Dental General Practice Past Accepting new patients
Lovell Dental General Practice Past Accepting new patients
Samuel C Davidson DDS LLC General Practice PastSince Sep 5, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1871857334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 WILLIAM ST",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688017432",
            "telephone_number": "307-751-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E MAIN ST",
            "city": "LOVELL",
            "state": "WY",
            "postal_code": "824312102",
            "telephone_number": "307-548-7654",
            "fax_number": "307-333-0345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "337 Greybull Ave",
            "address_purpose": "LOCATION",
            "city": "Greybull",
            "state": "WY",
            "postal_code": "824262049",
            "country_code": "US",
            "telephone_number": "307-765-4654",
            "fax_number": "307-333-0494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LANCE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-29",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lovell, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.