Derek Richard Damon, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DE7966 Issued in WA

Practice address

3400 Squalicum Pkwy
Suite 101
Bellingham, WA 98225-1933

Phone

(360) 676-6060

Fax

(360) 676-8662

NPI assigned

Mar 29, 2007

Last updated

Oct 26, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Derek R Damon DDS PS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Anacortes, WA
  • NPI 1003099466
  Authorized official Same address or phone
• Derek R Damon DDS PS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bellingham, WA
  • NPI 1114045366
  NPD (past) Authorized official

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351209600000",
    "number": "1063531051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SQUALICUM PKWY",
            "address_2": "SUITE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251933",
            "telephone_number": "360-676-6060",
            "fax_number": "360-676-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SQUALICUM PKWY",
            "address_2": "SUITE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251933",
            "telephone_number": "360-676-6060",
            "fax_number": "360-676-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMON",
        "first_name": "DEREK",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE7966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0278932",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marshall Aaron Dallas, D.C.
• Kellyanna M Dalton, L. AC.
• Mari Michelle Dalton, MA, MFT
• Maria Dalzot, RDN
• Dawn M Damon, SUDPT, AAC
• Dan Enselman LLC
• Christopher Clay Danenhower, M.D.
• Matthew Michael Dangleis, PA-C
• Mark Daniels, M.D.
• Jan Peter Dank, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.