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DR. KENNETH R ANDERSON JR. D.D.S
NPI 1992003370
Dentist in Lake Forest, IL

Active since March 08, 2011Opted out of Medicare · through May 23, 2028
810 S WAUKEGAN RD, LAKE FOREST, IL 60045(847) 295-0515 Get Directions Write a Review

NPPES record last updated: March 8, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kenneth R Anderson Jr. D.d.s NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH R ANDERSON JR. D.D.S (NPI 1992003370) is an individual dentist in Lake Forest, Illinois, licensed in Illinois (019019692) and active in the NPI registry since March 2011. He has opted out of Medicare through May 23, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1992003370
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. KENNETH R ANDERSON JR.Credential: D.D.S
Location Address810 S WAUKEGAN RDLake Forest, IL 60045-2693
Mailing Address810 S Waukegan RdLake Forest, IL 60045-2693 · (847) 295-0515
Phone(847) 295-0515
Sole ProprietorYes
Enumeration DateMarch 8, 2011
✔ NPI 1992003370 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IL · 019019692
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
810 S WAUKEGAN RD, Lake Forest, IL 60045
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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. Kenneth R Anderson Jr. D.d.s 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 May 23, 2016 through May 23, 2028.

Opt-Out Effective DateMay 23, 2016
Opt-Out In Effect ThroughMay 23, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60045 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$74.38 typical visit price
range $19.15 – $147.12
Typical copayment $18.59 (range $4.78 – $36.78)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROSEMARY SANTORO D.D.S
Dentist
810 S WAUKEGAN RD, SUITE 106
LAKE FOREST, IL 60045
Lake County (847) 295-0515
FOREST ORTHODONTICS AND PEDIATRIC DENTISTRY
Dentist (Pediatric Dentistry)
810 S WAUKEGAN RD, SUITE 101
LAKE FOREST, IL 60045
Lake County (847) 615-5437

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 Kenneth Anderson's NPI number?

The NPI number for Kenneth Anderson is 1992003370. It was assigned to this individual provider in the NPPES registry on March 8, 2011.

Where is Kenneth Anderson located?

Kenneth Anderson practices at 810 S Waukegan Rd, Lake Forest, IL 60045. The listed phone number is (847) 295-0515.

What is Kenneth Anderson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Kenneth Anderson enrolled in Medicare?

No. Kenneth Anderson has opted out of Medicare through May 23, 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.

When was this NPI record last updated?

The NPPES record for Kenneth Anderson was last updated on March 8, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.