Christopher C.M. Anderson, DENTURIST
Individual provider Active NPI Denturist · Poulsbo, WA
NPI 1962625780 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1962625780
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Denturist 122400000X
- License
- DN452 (WA)
- Practice address
- 19410 8TH Ave NE
Suite 102
Poulsbo, WA 98370-7379 - Phone
- (360) 779-1566
- Fax
- (360) 779-6879
- NPI assigned
- Apr 10, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN452 | WA | MD | Denturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaylee Wonder DMD PLLC | Past |
Accepting new patients | |
| Anderson Denture Center, Inc. | Denturist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Denturist | 122400000X | DN452 | WA | Yes |
Addresses
Primary practice location
19410 8TH Ave NE
Suite 102
Poulsbo, WA 98370-7379
Mailing address
19410 8TH Ave NE
Suite 102
Poulsbo, WA 98370-7379
Phone (360) 779-1566
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5051628 | Medicaid | WA |
Other providers in Poulsbo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.