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General NPI Number Information
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NPI Number | 1952735524
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Entity Type | Individual
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Provider Name | ROBERT E. ANDERSON DMD
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Gender | Male
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Dates
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Enumeration Date | 08/30/2013
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 4940 VAN NUYS BLVD STE 101
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1773
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Country | US
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Telephone | 818-789-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 14060 MARQUESAS WAY APT 2301
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City | MARINA DEL REY
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State | CA
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Zip | 90292-7499
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Country | US
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Telephone | 503-704-3957
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 62403
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License Number State | CA
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