Provider Demographics
NPI:1649713074
Name:DARIN ANDERSON, LLC
Entity type:Organization
Organization Name:DARIN ANDERSON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:N
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:907-349-3636
Mailing Address - Street 1:800 E DIMOND BLVD STE 3-600
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-2045
Mailing Address - Country:US
Mailing Address - Phone:907-349-3636
Mailing Address - Fax:907-349-7027
Practice Address - Street 1:800 E DIMOND BLVD STE 3-600
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-2045
Practice Address - Country:US
Practice Address - Phone:907-349-3636
Practice Address - Fax:907-349-7027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-03
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK14451223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1445OtherALASKA