NPIMap

Organization Active NPI

Robert E Anderson DDS a Professional Dental Corp

  • General Practice Dentistry
  • Placerville, CA
National Provider Identifier
1962793968
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
97193 Issued in CA
Legal business name
ROBERT E ANDERSON DDS A PROFESSIONAL DENTAL CORP
Practice address
4300 Golden Center Dr
Suite G
Placerville, CA 95667-6278
Phone
(530) 622-9068
Fax
(530) 622-9055
NPI assigned
Apr 25, 2011
Last updated
Apr 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Authorized official

Name
Dr. Robert E Anderson, D.D.S.NPI 1457571846
Title
President
Phone
(530) 622-9068

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 97193 CA Primary

Addresses

Primary practice location

4300 Golden Center Dr
Suite G
Placerville, CA 95667-6278

Mailing address

4300 Golden Center Dr
Suite G
Placerville, CA 95667-6278
Phone (530) 622-9068

National Provider Directory

National Provider Directory

Locations

4300 Golden Center Dr
Ste G
Placerville, CA 95667
Phone (503) 622-9068

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1962793968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 GOLDEN CENTER DR",
            "address_2": "SUITE G",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676278",
            "telephone_number": "530-622-9068",
            "fax_number": "530-622-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 GOLDEN CENTER DR",
            "address_2": "SUITE G",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676278",
            "telephone_number": "530-622-9068",
            "fax_number": "530-622-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT E ANDERSON DDS A PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-25",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-622-9068",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "97193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; 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.