NPIMap

Organization Active NPI

Derek R Damon DDS PS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Anacortes, WA
National Provider Identifier
1003099466
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DE7966 Issued in WA
Legal business name
DEREK R DAMON DDS PS
Practice address
1220 22ND St Ste a
Anacortes, WA 98221-2582
Phone
(360) 293-2888
Fax
(360) 299-0405
NPI assigned
Dec 8, 2007
Last updated
May 23, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
DEREK R DAMON DDS PSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 23, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Derek Richard Damon, DDSNPI 1063531051
Title
Owner
Phone
(360) 676-6060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X DE7966 WA Primary

Addresses

Primary practice location

1220 22ND St Ste a
Anacortes, WA 98221-2582

Mailing address

1220 22ND St Ste a
Anacortes, WA 98221-2582
Phone (360) 293-2888

National Provider Directory

National Provider Directory
Tax ID family
Derek R Damon DDS PS2 organizations share this tax ID, including this one
Part of
Derek R Damon DDS PS

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558569600000",
    "number": "1003099466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 22ND ST STE A",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212582",
            "telephone_number": "360-293-2888",
            "fax_number": "360-299-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 22ND ST STE A",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212582",
            "telephone_number": "360-293-2888",
            "fax_number": "360-299-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK R DAMON DDS PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEREK R DAMON DDS PS",
        "enumeration_date": "2007-12-08",
        "last_updated": "2019-05-23",
        "status": "A",
        "authorized_official_last_name": "DAMON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-676-6060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE7966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anacortes, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.