NPIMap

Organization Active NPI

Derek R Damon DDS PS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bellingham, WA
National Provider Identifier
1114045366
Registry record updated Aug 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DE 7966 Issued in WA
Legal business name
DEREK R DAMON DDS PS
Practice address
3400 Squalicum Pkwy
Suite 101
Bellingham, WA 98225-1933
Phone
(360) 676-6060
Fax
(360) 676-8662
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2012

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
President
Phone
(360) 676-6060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X DE 7966 WA Primary

Addresses

Primary practice location

3400 Squalicum Pkwy
Suite 101
Bellingham, WA 98225-1933

Mailing address

3400 Squalicum Pkwy
Suite 101
Bellingham, WA 98225-1933
Phone (360) 676-6060

National Provider Directory

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

Other organizations with this tax ID 1

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

Locations

3400 Squalicum Pkwy
Ste 101
Bellingham, WA 98225
Phone (360) 676-6060

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344211200000",
    "number": "1114045366",
    "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": {
        "organization_name": "DEREK R DAMON DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2012-08-06",
        "status": "A",
        "authorized_official_last_name": "DAMON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "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": "DE 7966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.