Ross Allen Anderson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12791 Issued in MN

Practice address

1225 E 1St St
Duluth, MN 55805-2402

Phone

(218) 728-6445

NPI assigned

Apr 18, 2010

Last updated

Apr 27, 2012By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

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.

• Lake Superior Dental Associates

  • General Practice Dentistry
  • Duluth, MN
  • NPI 1871672584
  Medicare reassignment
• Sla Dental PLLC

  • General Practice Dentistry
  • Duluth, MN
  • NPI 1669894705
  NPD (past)

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

{
    "created_epoch": "1271548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335484800000",
    "number": "1891011748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052402",
            "telephone_number": "218-728-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E 1ST ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052402",
            "telephone_number": "218-728-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROSS",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-18",
        "last_updated": "2012-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MN",
            "license": "D12791",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Ann Anderson
• Neil J Anderson, CRNA
• Paul Richard Anderson
• Robb Evan Anderson
• Robin Joy Anderson
• Ryan Taylor Anderson
• Sally L Anderson
• Sarah Elizabeth Anderson, MA
• Sharla Kay Anderson, RN
• Sharon Wessel Anderson, WHNP

• General Practice Dentistry in Duluth, MN
• Providers in Duluth, 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 Apr 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.