Individual provider Active NPI

Cameron Hamidi, D.D.S

  • Periodontics
  • Washington, DC
National Provider Identifier
1174702542
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
1001842 Issued in DC
Practice address
1712 I St NW Ste 202
Washington, DC 20006-3744
Phone
(614) 598-2078
NPI assigned
Nov 1, 2007
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 102115 CA
Periodontics 1223P0300X 1001842 DC Primary
Periodontics 1223P0300X 27324 TX

Addresses

Primary practice location

1712 I St NW Ste 202
Washington, DC 20006-3744

Mailing address

10665 Laurel Path
Escondido, CA 92026-7320
Phone (614) 598-2078

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
102115CAMDPeriodontist
1001842DCMDPeriodontist
27324TXMDPeriodontist

Organizations & group practices 1

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": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1174702542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10665 LAUREL PATH",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920267320",
            "telephone_number": "614-598-2078",
            "fax_number": "614-598-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 I ST NW STE 202",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200063744",
            "telephone_number": "614-598-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMIDI",
        "first_name": "CAMERON",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-01",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "102115",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "DC",
            "license": "1001842",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "27324",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.