Healthcare Provider Details

I. General information

NPI: 1861376303
Provider Name (Legal Business Name): J TANNER ANDERSON DDS MS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 WESTBROOK PLAZA DR STE 103
WINSTON SALEM NC
27103-1355
US

IV. Provider business mailing address

1551 WESTBROOK PLAZA DR STE 103
WINSTON SALEM NC
27103-1355
US

V. Phone/Fax

Practice location:
  • Phone: 336-760-9229
  • Fax: 336-742-8750
Mailing address:
  • Phone: 336-760-9229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH TANNER ANDERSON
Title or Position: OWNER
Credential: DDS, MS
Phone: 828-443-9491