DR. JOHN FRED ANDERSON JR. DDS, MD
NPI 1780123216
Dentist - Oral and Maxillofacial Surgery in Pacific Palisades, CA
About Dr. John Fred Anderson Jr. Dds, Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JOHN FRED ANDERSON JR. DDS, MD (NPI 1780123216) is an individual oral and maxillofacial surgery provider in Pacific Palisades, California, licensed in California (DDS108647) and active in the NPI registry since February 2017. He has opted out of Medicare through March 20, 2028 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Dr. John Fred Anderson Jr. Dds, Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 20, 2026 through March 20, 2028.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90272 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is John Anderson's NPI number?
The NPI number for John Anderson is 1780123216. It was assigned to this individual provider in the NPPES registry on February 16, 2017.
Where is John Anderson located?
John Anderson practices at 17093 Palisades Cir, Pacific Palisades, CA 90272. The listed phone number is (310) 717-6456.
What is John Anderson's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.
Is John Anderson enrolled in Medicare?
No. John Anderson has opted out of Medicare through March 20, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.
What insurance does John Anderson accept?
Health plans from Humana and Renaissance Dental list John Anderson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for John Anderson was last updated on July 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. John Fred Anderson Jr., DDS, MD · NPI 1780123216
Oral and Maxillofacial Surgery provider in Pacific Palisades, California. Individual provider, active in the CMS NPPES registry since February 16, 2017.
## Identity
- **NPI:** 1780123216 (Entity type: Individual)
- **Enumerated:** February 16, 2017
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **State license:** DDS108647 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 17093 PALISADES CIR, Pacific Palisades, CA 90272-2139
- **Phone:** (310) 717-6456
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through March 20, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** July 19, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1780123216) · Data from the CMS NPPES public registry.