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DR. KENNETH MARK ANDERSON DDSMS NPI 1245316017


NPI Information

NPI: 1245316017
Provider Name: DR. KENNETH MARK ANDERSON, DDS,MS
Classification: Dentist - 1223P0106X
Entity Type: Individual

Specialization: Oral and Maxillofacial Pathology

PECOS Registration: Yes

Address:
875 UNION AVE
ROOM C309
MEMPHIS, TN
ZIP 38163
Phone: (901) 448-5876
Get Directions

DR. Kenneth Mark Anderson, DDS,MS is an oral and maxillofacial pathology dentist in Memphis, TN. The provider is the specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. DR. Kenneth Mark Anderson, DDS,MS NPI is 1245316017. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

875 UNION AVE
ROOM C309
MEMPHIS, TN
ZIP 38163-001
Phone: (901) 448-5876
Fax: (901) 448-6835

The NPI 1245316017 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/27/2006 and was last updated on 9/5/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0106XDentistOral and Maxillofacial PathologyDDS8053TENNESSEEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14075323OTHERTENNESSEEBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.