DR. DAVID CHARLES ANDERSON (NPI# 1083624621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083624621 |
| Entity Type | Individual |
| Full Name | DR. DAVID CHARLES ANDERSON |
| Credential | DDS |
| Practice Address |
430 Main St Green Bay WI 54301-5115 |
| Mailing Address |
5318 North Rosemary Lane Appleton WI 54913 |
| Practice Telephone | 9204310345 |
| Mailing Telephone | 9207309027 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
5956 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33798200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942819875 | David Melville Anderson | Technician | 2558 S Anaheim St Apt 102, Aurora, CO 80014-1482 | 2020-07-27 |
| 1023645447 | David Allen Anderson | Nursing Care | 7746 Orchard Village Dr, Indianapolis, IN 46217-2907 | 2020-03-25 |
| 1467956615 | David Edward Anderson | Counselor | 4747 Arapahoe Ave Dept Case, Boulder, CO 80303-1131 | 2018-03-22 |
| 1548672702 | David Anderson | Dentist | 4207 W Electra Ln, Glendale, AZ 85310-5571 | 2014-05-22 |
| 1518390020 | David Anderson | Pharmacist | 3615 Gibraltar Dr, Reno, NV 89509-5617 | 2013-08-20 |
| 1518301217 | David Allen Anderson | Counselor | 13568 Sw 61st Ave, Suite 315, Portland, OR 97219-8132 | 2013-04-24 |
| 1316272636 | David Paul Anderson | Chiropractor | 10585 Scripps Poway Parkway, #c, San Diego, CA 92131 | 2009-10-05 |
| 1568695435 | David Robert Anderson II | Pharmacist | 202 Market St Ste J, Cramerton, NC 28032-1148 | 2009-08-26 |
| 1093946469 | David John Anderson | Dentist | 5192 Dawes Avenue, Alexandria, VA 22311 | 2009-08-04 |
| 1396995247 | David Marshall Anderson | Psychologist | 101 E 56th St, New York, NY 10022 | 2008-09-29 |
| Street Address |
430 MAIN ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54301-5115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154326924 | John E Zweig | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2005-06-16 |
| 1861025090 | Keith Davis | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2020-02-17 |
| 1780232827 | Pranav Bhide | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2019-09-02 |
| 1174180301 | Lalinda Wickramasinghe | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2019-05-23 |
| 1063906188 | Hassan Alshehabi | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2018-06-21 |
| 1235621756 | Jiulin Zhu | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2018-05-31 |
| 1902323298 | Gergana Naskova Nikolova | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2017-08-28 |
| 1922528157 | Pamela Sehra | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2017-06-20 |
| 1982098323 | Jennifer Yessa | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2015-03-24 |
| 1841681525 | Farashta Sediqzad | Dentist | 430 Main St, Green Bay, WI 54301-5115 | 2015-02-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102465 | Parc Village Dental, LLC | Dentist | 2805 Libal Street, Suite A, Green Bay, WI 54301 | 2019-03-07 |
| 1598229478 | Shaina Marie Conner | Registered Nurse | 835 S Vanburen St, Green Bay, WI 54301 | 2019-01-25 |
| 1093298960 | Brown County | Case Management | 111 N. Jefferson Street, Green Bay, WI 54301 | 2018-09-07 |
| 1639609928 | Frontline Healthcare LLC | Specialist/Technologist, Other | 2221 S. Webster Ave. Suite 270, Greenbay, WI 54301 | 2017-06-19 |
| 1992242606 | Charmaine Rimple | Counselor | 526 South Monroe Avenue, Green Bay, WI 54301 | 2017-01-20 |
| 1962944819 | Rebecca Lucille Reinbold | Registered Nurse | 917 Catherine Street, Green Bay, WI 54301 | 2016-11-09 |
| 1730635061 | Melissa Kristof | Specialist/Technologist, Other | 1821 Sounth Webster Ave., Green Bay, WI 54301 | 2016-08-28 |
| 1255709747 | Vivian Sweetheart Bishop-cook | Counselor | 2920 South Webster Ave, Green Bay, WI 54301 | 2015-09-14 |
| 1881079960 | Chelsi S Weber | Registered Nurse | 2300 Riverside Dr., Ste 204, Green Bay, WI 54301 | 2015-07-30 |
| 1962816371 | Joelle M Hesse | Counselor | 630 Cherry St., Green Bay, WI 54301 | 2014-06-13 |
| Find all providers in zip 54301 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083899496 | Jeffrey Scott Ryther | Dentist | 1901 S Webster Ave, Suite 8, Green Bay, WI 54301-2281 | 2008-01-03 |
| 1841419587 | Nicolas Abujamra Dds Ms Ltd | Dentist | 2581 Development Dr, Suite 102, Green Bay, WI 54311-4247 | 2007-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679132815 | Wisconsin Oral Surgery LLC | Dentist | 10401 W Lincoln Ave Ste 101, West Allis, WI 53227-1255 | 2019-06-11 |
| 1871949107 | Alicia Estrella | Dentist | 406 Science Dr Ste 402, Madison, WI 53711-1068 | 2016-05-05 |
| 1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
| 1194066167 | Christman Dental, Ltd | Dentist | 425 W Prairie View Road, Chippewa Falls, WI 54729-3389 | 2013-03-15 |
| 1033482500 | Rupal Suresh Vasani | Dentist | 2501 County Highway I, Chippewa Falls, WI 54729-1422 | 2012-02-14 |
| 1659654127 | Eon Clinics | Dentist | 20700 Swenson Dr, Waukesha, WI 53186-0900 | 2011-09-21 |
| 1053641126 | Jerry W Walker | Dentist | 6060 N Bay Ridge Ave, Milwaukee, WI 53217-4663 | 2010-01-12 |
| 1972742039 | Dean W Crow | Dentist | 2314 N. Grandview Blvd, Suite 206, Waukesha, WI 53188-1675 | 2009-02-13 |
| 1912143439 | David Joseph Kachelmeyer | Dentist | 1331 W Birch Ct, Milwaukee, WI 53209-5118 | 2009-01-06 |
| 1457531675 | Todd Russell Krueger | Dentist | 8531 W Lincoln Ave, West Allis, WI 53227-2542 | 2007-11-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.