Brock Alexander Cameron, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2019022716 Issued in MO

Practice address

3115 N Highway 67
Florissant, MO 63033-1602

Phone

(314) 451-0001

NPI assigned

Jun 24, 2019

Last updated

Jun 24, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Brock a. Cameron, DMD, LLC

  dba Edwards Dental

  • Dental Clinic/Center
  • Saint Louis, MO
  • NPI 1124747589
  NPD Authorized official
• Mann Dental LLC

  • General Practice Dentistry
  • Florissant, MO
  • NPI 1003582966
  NPD (past)

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1215598099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 S 9TH ST APT 231",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631044731",
            "telephone_number": "618-977-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 N HIGHWAY 67",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630331602",
            "telephone_number": "314-451-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMERON",
        "first_name": "BROCK",
        "middle_name": "ALEXANDER",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2019022716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanta L Caldwell, COTA
• Jada Nailah Calicutt, DOULA
• Call of Duty CDS II
• Call of Duty Home Healthcare II
• Delores Calmese, FNP
• Amanda A Campbell
• Ana Capilla
• Care 4 Life Medical Resources, LLC
• Care 4 Life Medical Resources, LLC
• Care at the Palm of Your Hands Health Servicesllc

• General Practice Dentistry in Florissant, MO
• Providers in Florissant, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.