Active NPI
Eric Michael Anderson, DMD
- General Practice Dentistry
- Duluth, GA
National Provider Identifier
1881114015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN015445
- Practice address
- 2925 Premiere Pkwy Ste 165
Duluth, GA 30097-5258 - Phone
- (678) 417-9656
- NPI assigned
- Jun 20, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN015445 | GA | Primary |
Addresses
Primary practice location
2925 Premiere Pkwy Ste 165
Duluth, GA 30097-5258
Mailing address
2925 Premiere Pkwy Ste 165
Duluth, GA 30097-5258
Phone (678) 417-9656
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 |
|---|---|---|---|
| DN015445 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anderson and Anderson DMD PC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1881114015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 PREMIERE PKWY STE 165",
"city": "DULUTH",
"state": "GA",
"postal_code": "300975258",
"telephone_number": "678-417-9656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2925 PREMIERE PKWY STE 165",
"city": "DULUTH",
"state": "GA",
"postal_code": "300975258",
"telephone_number": "678-417-9656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ERIC",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN015445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.