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Darian L Anderson

Dentist

Dental Providers

2995 Clairemont Dr Ste A, San Diego, CA 92117-6766

PECOS Enrollment

This provider is enrolled in PECOS as DARIAN ANDERSON.

Based on the most recent information from CMS, provider Darian L Anderson is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1588349716
Provider Type
Individual
Full Name
Anderson, Darian L
Title
Dr.
Credential
D.D.S.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
6/15/2023
Last Updated
6/15/2023

Contact Information

Practice Location

2995 Clairemont Dr Ste A, San Diego, CA 92117-6766

(858) 200-0827

Unlisted Fax

Mailing Location

1237 Amherst Ave Apt 4, Los Angeles, CA 90025-1100

(202) 213-9835

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 122300000X Primary	Description Dentist Dental Providers	License 108865 California

Darian L Anderson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Sharma, Indra S

Liu, Molly San Si Hsam

Mallari, Danica Charisma

Fariba, Tina S

Bancroft, Lindsay

Lockwood, David Gordon

Liu Dental Corp

Srinivasan, Hemamalini

Mankatala, Suryadeep Singh

Tyszkowski, Nicole