DR. RUSSELL G. ANDERSON JR. D.M.D.
NPI 1811068620
Dentist - General Practice in Kennesaw, GA
NPI Status: Active since November 13, 2006
Contact Information
1415 WOOTEN LAKE RD NW
SUITE 300
KENNESAW, GA
ZIP 30144
Phone: (770) 419-2535
Fax: (770) 419-0030
- Individual
- Male
- Dentist
- General Practice
- Opted-Out Medicare
About RUSSELL ANDERSON
This page provides the complete NPI Profile along with additional information for Russell Anderson, a provider established in Kennesaw, Georgia with a medical specialization in Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1811068620 assigned on November 2006. The practitioner's primary taxonomy code is 1223G0001X with license number 011457 (GA). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1811068620
- Provider Name
- DR. RUSSELL G. ANDERSON JR. D.M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1415 WOOTEN LAKE RD NW SUITE 300 KENNESAW, GA 30144
- Location Phone
- (770) 419-2535
- Location Fax
- (770) 419-0030
- Mailing Address
- 1415 WOOTEN LAKE RD NW SUITE 300 KENNESAW, GA 30144
- Mailing Phone
- (770) 419-2535
- Mailing Fax
- (770) 419-0030
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 11-13-2006
- Last Update Date
- 07-08-2007
- Code Navigator
A dentist like Russell Anderson is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Russell Anderson opted out of Medicare effective on 09-06-2018 until 09-06-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist General Practice
- Taxonomy Code
- 1223G0001X
- Type
- Dental Providers
- License No.
- 011457
- License State
- GA
- Taxonomy Description
- A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 09-06-2018
Opt-Out End Date: 09-06-2026
Eligible to Order and Refer? No
Reviews for DR. RUSSELL G. ANDERSON JR. D.M.D.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 8 | 1 | 1 | 0 | 6 | 8 | 6 | 2 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 2 | 1 | 0 | 6 | 16 | 6 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 2 + 1 + 0 + 6 + 1 + 6 + 6 + 4 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1811068620 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 7 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1467421073 | MR. CHRIS HOBSON O.D. Individual | Optometrist | 1415 WOOTEN LAKE RD NW SUITE 100 KENNESAW, GA 30144 (770) 424-2020 |
| 1174772859 | GEORGIA OPHTHALMOLOGY REFERRAL CENTER, LLC Organization | Ophthalmology | 1415 WOOTEN LAKE RD NW SUITE 130 KENNESAW, GA 30144 (866) 527-3722 |
| 1043349368 | TASMAN EYE CONSULTANTS PC Organization | Optometrist | 1415 WOOTEN LAKE RD NW SUITE 100 KENNESAW, GA 30144 (770) 792-3937 |
| 1023557931 | RYAN CHIHIEN TIEU O.D. Individual | Optometrist | 1415 WOOTEN LAKE RD NW KENNESAW, GA 30144 (770) 792-3937 |
| 1841361920 | H & T EYE GROUP, LLC Organization | Optometrist | 1415 WOOTEN LAKE RD NW KENNESAW, GA 30144 (770) 424-8101 |
| 1881436210 | LAUREN ELIZABETH DANIEL OD Individual | Optometrist | 1415 WOOTEN LAKE RD NW KENNESAW, GA 30144 (770) 573-4345 |
| 1396066072 | JONATHAN WOOLFSON MD, PC Organization | Ophthalmology | 1415 WOOTEN LAKE RD NW SUITE 100 KENNESAW, GA 30144 (770) 424-8101 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1811068620, enumerated in the NPI registry as an "individual" on November 13, 2006
The provider is located at 1415 Wooten Lake Rd Nw Suite 300 Kennesaw, Ga 30144 and the phone number is (770) 419-2535
The provider's speciality is Dentist with taxonomy code 1223G0001X with a focus in General Practice
No, the provider signed an affidavit on September 06, 2018 to opt-out of the Medicare program. The provider is excluded from the Medicare program until September 06, 2026.
This NPI record was last updated on November 13, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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