Organization Active NPI

Dr. Clifton Cameron & Associates of Heritage Junction, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Wake Forest, NC
National Provider Identifier
1194489930
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
DR. CLIFTON CAMERON & ASSOCIATES OF HERITAGE JUNCTION, PLLC
Practice address
2824 Rogers Rd Ste 200
Wake Forest, NC 27587-3896
Phone
(919) 453-6325
NPI assigned
Oct 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Chad Hendricks
Title
Credentialing
Phone
(612) 859-0444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

2824 Rogers Rd Ste 200
Wake Forest, NC 27587-3896

Mailing address

2824 Rogers Rd Ste 200
Wake Forest, NC 27587-3896
Phone (919) 453-6325

National Provider Directory

National Provider Directory

Locations

2824 Rogers Rd
Ste 102
Wake Forest, NC 27587
Phone (919) 229-8363

Practitioners & affiliated clinicians

Practitioners 2

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": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1194489930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2824 ROGERS RD STE 200",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873896",
            "telephone_number": "919-453-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 ROGERS RD STE 200",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275873896",
            "telephone_number": "919-453-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. CLIFTON CAMERON & ASSOCIATES OF HERITAGE JUNCTION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.