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Deactivated NPI 1083710404 Deactivated / Inactive NPI Male Practitioner

Dr. Bruce Woodruff Anderson , DDS

Dentist - General Practice • Bloomington, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Bruce Anderson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 15, 2006
NPI Deactivation Date March 05, 2026
Total Practice Duration ~20 Years of Practice (2006 – 2026)

Professional Overview & Biography Verified Profile Summary

Dr. Bruce Anderson, DDS was a registered Dentist - General Practice practicing in Bloomington, IL. Throughout an active medical career spanning 20 years, Dr. Anderson provided care at the practice location at 2310 E OAKLAND AVE STE 13A until profile deactivation on 2026-03-05.

Practice Location & Contact Primary Location

Practice Address

2310 E Oakland Ave Ste 13a

Bloomington, IL 617015884

Telephone 3096621612
Fax 3096620610

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Bloomington, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
44 Specialists

Practicing in Bloomington, IL (5581 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL 019-14006

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 05, 2026

Record deactivated on March 05, 2026

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2310 E OAKLAND AVE STE 13A, BLOOMINGTON, IL 617015884 (Tel: 3096621612)

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Updated Business Mailing Address July 08, 2007

Registered at 2310 E OAKLAND AVE STE 13A, BLOOMINGTON, IL 617015884 (Tel: 3096621612)

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Provider Name / Credentials Updated July 08, 2007

Recorded as BRUCE ANDERSON, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #019-14006 in IL)

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Initial NPI Registration & Enumeration September 15, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1083710404
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 15, 2006
Last Update: July 08, 2007
Deactivation Date: March 05, 2026

Mailing Address

2310 E Oakland Ave Ste 13a

Bloomington, IL 617015884

Phone: 3096621612

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.