JONATHON HENNING ANDERSON (NPI# 1811979719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811979719 |
| Entity Type | Individual |
| Full Name | JONATHON HENNING ANDERSON |
| Credential | DDS |
| Practice Address |
555 S Old Woodward Ave Ste 777 Birmingham MI 48009-6618 |
| Practice Telephone | 2486474700 |
| Practice Fax Number | 2486474730 |
| Mailing Telephone | 2486474700 |
| Mailing Fax Number | 2486474730 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2018-10-15 |
| NPI Deactivation Date | 09/24/2018 |
| NPI Reactivation Date | 2018-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2901012981 | MI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4067429 | 05 | |
| MI | LICENSE NUMBER | JA012981 | 01 |
| MI | BCBSM | 970F31085 | 01 |
| MI | 2990516 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619920915 | Jonathon Michael Anderson | Chiropractor | 207 N. Main, Syracuse, KS 67878 | 2006-05-18 |
| 1801359740 | Jonathon Logan Anderson | Student in an Organized Health Care Education/Training Program | 920 Madison Avenue Suite 447, Memphis, TN 38163-4400 | 2019-04-08 |
| 1689939118 | Jonathon Grey Anderson | Internal Medicine | 101 W 8th Ave, Spokane, WA 99204-2364 | 2012-07-11 |
| 1184901431 | Jonathon L Anderson | Pharmacist | 7398 N Lindbergh Blvd, Hazelwood, MO 63042-2033 | 2011-11-14 |
| Street Address |
555 S OLD WOODWARD AVE STE 777 |
| City | BIRMINGHAM |
| State | MI |
| Zip Code | 48009-6618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598255044 | Birmingham Oral & Maxillofacial Surgery, Plc | Dentist | 555 S Old Woodward Ave Ste 777, Birmingham, MI 48009 | 2018-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487183836 | Carolyn Joanna Archer | Dietitian, Registered | 1155 Derby Rd, Apt 3, Birmingham, MI 48009 | 2017-06-08 |
| 1912374695 | Valerie Kim Kaplansky | Counselor | 300 E. Maple Road, 315, Birmingham, MI 48009 | 2015-08-28 |
| 1578956348 | Nancy Jane Naski | Recreation Therapist | 623 Hanna St, Birmingham, MI 48009 | 2015-03-18 |
| 1619370236 | Caitlin Stoltman | Recreation Therapist | 1669 W. Maple Rd., Far, Birmingham, MI 48009 | 2014-09-28 |
| 1295140770 | Lauren Elizabeth Perlin | Obstetrics & Gynecology | 35046 Woodward Ave Ste 100, Birmingham, MI 48009 | 2014-06-24 |
| 1235560764 | Better Life Learning | Community/Behavioral Health | 33717 Woodward Ave #253, Birmingham, MI 48009 | 2013-12-10 |
| 1689949034 | Drs Housecalls PC | Internal Medicine | 298 S. Old Woodward, Birminham, MI 48009 | 2012-03-19 |
| 1689942021 | Brian Connolly Md PC | Psychiatry & Neurology | 189 Townsend, Suite 300, Birmingham, MI 48009 | 2011-12-13 |
| 1619204187 | Dr. Lori PC | Dermatology | 353 South Old Woodward Ave, Birmingham, MI 48009 | 2009-11-04 |
| 1033348453 | Jason Eric Gregory | Music Therapist | 1669 West Maple, Birmingham, MI 48009 | 2009-07-07 |
| Find all providers in zip 48009 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710196506 | Lisa Miller | Dentist | 1 Inverness Center Pkwy Ste 200, Birmingham, AL 35242-4865 | 2007-05-21 |
| 1063506533 | Harold Newton Burton | Dentist | 1771 Independence Court, Suite 2, Birmingham, AL 35216 | 2006-10-02 |
| 1982719639 | William Pettus Buck Jr. | Dentist | 1112 19th St S, Birmingham, AL 35205-4814 | 2006-08-21 |
| 1578677233 | Christopher Michael Rothman | Dentist | 2290 Valleydale Road, Suite 100, Birmingham, AL 35244-2011 | 2006-08-19 |
| 1669441333 | Dennis Dale Carr | Dentist | 101 Heatherbrooke Park Dr, Birmingham, AL 35242-8008 | 2006-03-16 |
| 1497739494 | Jon D Holmes | Dentist | 1500 19th St S, Suite 200, Birmingham, AL 35205-5628 | 2005-12-02 |
| 1881236883 | Blake Phillips D.m.d., P.C. | Dentist | 1112 19th St S, Birmingham, AL 35205-4814 | 2019-10-10 |
| 1003378274 | Ryan Chase Seeley | Dentist | 1919 7th Ave S, Birmingham, AL 35233-2005 | 2019-04-04 |
| 1598255044 | Birmingham Oral & Maxillofacial Surgery, Plc | Dentist | 555 S Old Woodward Ave Ste 777, Birmingham, MI 48009 | 2018-05-10 |
| 1447643523 | Shelby Oral Facial Surgery | Dentist | 1 Inverness Center Pkwy, Suite 200, Birmingham, AL 35242-4817 | 2015-03-12 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 48009 |
Please comment or provide details below to improve the information on JONATHON HENNING ANDERSON.
| 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.