Provider Demographics
NPI:1023437472
Name:JOAN I ANDERSON & CO
Entity type:Organization
Organization Name:JOAN I ANDERSON & CO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:ISABELL
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-705-0102
Mailing Address - Street 1:1971 EVELYN BYRD AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3477
Mailing Address - Country:US
Mailing Address - Phone:540-705-0102
Mailing Address - Fax:540-246-0663
Practice Address - Street 1:1971 EVELYN BYRD AVE
Practice Address - Street 2:SUITE F
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3477
Practice Address - Country:US
Practice Address - Phone:540-705-0102
Practice Address - Fax:540-246-0663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402206209124Q00000X
VA0401413162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Single Specialty