NPIMap

Organization Active NPI

Anderson Dental Associates III, PLLC

  • Dental Clinic/Center
  • Woodbridge, VA
National Provider Identifier
1992303242
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
ANDERSON DENTAL ASSOCIATES III, PLLC
Practice address
15609 Wingspan CT
Woodbridge, VA 22193-1103
Phone
(860) 817-2787
NPI assigned
Oct 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Authorized official

Name
Joshua Wilfredo AndersonNPI 1912105438
Title
Dentist
Phone
(860) 817-2787

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

15609 Wingspan CT
Woodbridge, VA 22193-1103

Mailing address

2719 Washington Blvd
Arlington, VA 22201-1942
Phone (703) 243-1810

National Provider Directory

National Provider Directory

Locations

2719 Washington Blvd
Arlington, VA 22201
Phone (703) 243-1810

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1992303242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2719 WASHINGTON BLVD",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222011942",
            "telephone_number": "703-243-1810",
            "fax_number": "703-243-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15609 WINGSPAN CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931103",
            "telephone_number": "860-817-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON DENTAL ASSOCIATES III, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-09",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "WILFREDO",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "860-817-2787"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

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

Verify at the official NPI Registry.