Individual provider Active NPI

James Adam Damascus, DDS

  • Dentist
  • Ridgefield, CT
National Provider Identifier
1194759969
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
005481 Issued in CT
Practice address
22 Prospect St
Ridgefield, CT 06877-4510
Phone
(203) 894-8300
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 005481 CT Primary

Addresses

Primary practice location

22 Prospect St
Ridgefield, CT 06877-4510

Mailing address

22 Prospect St
Ridgefield, CT 06877-4510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160128001771 NY Order and Referring Only - DentistPractitioner - Dentist 0143523936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005481CTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194759969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PROSPECT ST",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PROSPECT ST",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774510",
            "telephone_number": "203-894-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMASCUS",
        "first_name": "JAMES",
        "middle_name": "ADAM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "005481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, CT

Sources for this page

Verify at the official NPI Registry.