Clifton S. Cameron DDS II-Leesville, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

CLIFTON S. CAMERON DDS II-LEESVILLE, PLLC

Doing business as

Vista Oral Surgery and Implants - Raleigh

Practice address

9305 Leesville Rd Ste 102
Raleigh, NC 27613-7603

Phone

(919) 964-2722

NPI assigned

May 1, 2024

Organization subpart

No

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

Authorized official

Name

Marina R

Title

Credentialing Specialist

Phone

(202) 630-3939

Specialties & licenses 3

Addresses

Other names 1

• Vista Oral Surgery and Implants - Raleigh Doing business as

Locations

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1366299091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9305 LEESVILLE RD STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276137603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9305 LEESVILLE RD STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276137603",
            "telephone_number": "919-964-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON S. CAMERON DDS II-LEESVILLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-01",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "R",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "202-630-3939"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Oral Surgery and Implants - Raleigh",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vista Oral Surgery and Implants - Raleigh",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• British Elizabeth Clemons
• Emily D Clendenin, COTA/L
• Amanda Clerkin, MSW, LCSW
• Client Journey Counseling & Consulting
• Mackenzie Shae Clifford
• Clifton S. Cameron, D.D.S. III - Leesville, PLLC
• Stephanie Y. Clifton-Pace, PHARMD
• Doug Clifton, OPTICIAN
• Jeffrey T Cline
• Marina Esther Cline, LPC

• Oral and Maxillofacial Surgery (Dentist) in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

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