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Deactivated NPI 1205842192 Deactivated / Inactive NPI Male Practitioner

Robert Larry Anderson , DDD, PC

Dentist - General Practice • Waterloo, IA

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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, Robert Anderson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 31, 2006
NPI Deactivation Date June 12, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Robert Anderson, DDD, PC was a registered Dentist - General Practice practicing in Waterloo, IA. Throughout an active medical career spanning 19 years, Robert Anderson provided care at the practice location at 526 W MULLAN AVE until profile deactivation on 2025-06-12.

Practice Location & Contact Primary Location

Practice Address

526 W Mullan Ave

Waterloo, IA 507011544

Telephone 3192342775
Fax 3192361748

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Waterloo, IA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 1.0 Yrs
State Avg: 9.0 Yrs
Regional Practice Density
34 Specialists

Practicing in Waterloo, IA (1303 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 IA 5606BJ-0006

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 June 12, 2025

Record deactivated on June 12, 2025

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 526 W MULLAN AVE, WATERLOO, IA 507011544 (Tel: 3192342775)

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Updated Business Mailing Address July 08, 2007

Registered at 526 W MULLAN AVE, WATERLOO, IA 507011544 (Tel: 3192342775)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT ANDERSON, D.D.D.,P.C.

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

Dentist (License #5606BJ-0006 in IA)

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Initial NPI Registration & Enumeration July 31, 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: 1205842192
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 31, 2006
Last Update: July 08, 2007
Deactivation Date: June 12, 2025

Mailing Address

526 W Mullan Ave

Waterloo, IA 507011544

Phone: 3192342775

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.