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

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  • 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 19 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

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1811068620, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
1
Doubled → 2
Pos 4
1
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
6
Unchanged
Pos 9
2
Doubled → 4
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 0 → 0 8 → 16 → 7 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 2 + 1 + 0 + 6 + 1 + 6 + 6 + 4 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1811068620.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Optometrist
1415 WOOTEN LAKE RD NW, SUITE 100
KENNESAW, GA 30144
Ophthalmology
1415 WOOTEN LAKE RD NW, SUITE 130
KENNESAW, GA 30144
Optometrist
1415 WOOTEN LAKE RD NW, SUITE 100
KENNESAW, GA 30144
Optometrist
1415 WOOTEN LAKE RD NW
KENNESAW, GA 30144
Optometrist
1415 WOOTEN LAKE RD NW
KENNESAW, GA 30144
Optometrist
1415 WOOTEN LAKE RD NW
KENNESAW, GA 30144
Ophthalmology
1415 WOOTEN LAKE RD NW, SUITE 100
KENNESAW, GA 30144

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1811068620, enumerated 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.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.