Active NPI
Brian Craig Anderson, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Park City, UT
National Provider Identifier
1881087518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 8715278-9921
- Practice address
- 1830 Prospector Ave
Park City, UT 84060-7319 - Phone
- (435) 649-6959
- NPI assigned
- Mar 4, 2015
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 8715278-9921 | UT | Primary |
Addresses
Primary practice location
1830 Prospector Ave
Park City, UT 84060-7319
Mailing address
2420 E Wrenhaven LN
Salt Lake City, UT 84121-2365
Phone (801) 891-5580
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8715278-9921 | UT | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425427200000",
"number": "1881087518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2420 E WRENHAVEN LN",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841212365",
"telephone_number": "801-891-5580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 PROSPECTOR AVE",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840607319",
"telephone_number": "435-649-6959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "BRIAN",
"middle_name": "CRAIG",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-03-04",
"last_updated": "2015-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "UT",
"license": "8715278-9921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.