Individual provider Active NPI

Paul Cameron, D.D.S.

  • Dentist
  • Corte Madera, CA
National Provider Identifier
1063878650
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
42980 Issued in CA
Practice address
81 Casa Buena Dr Ste 4
Corte Madera, CA 94925-1710
Phone
(415) 924-4435
Fax
(415) 924-7421
NPI assigned
Jan 12, 2016
Last updated
Jan 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 42980 CA Primary

Addresses

Primary practice location

81 Casa Buena Dr Ste 4
Corte Madera, CA 94925-1710

Mailing address

81 Casa Buena Dr Ste 4
Corte Madera, CA 94925-1710
Phone (415) 924-4435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
42980CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Cameron, DDS Dentist Past Accepting new patients
Fred J Cameron DDS Inc Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1063878650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 CASA BUENA DR STE 4",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251710",
            "telephone_number": "415-924-4435",
            "fax_number": "415-924-7421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 CASA BUENA DR STE 4",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251710",
            "telephone_number": "415-924-4435",
            "fax_number": "415-924-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "42980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corte Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; 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.