Individual provider Active NPI

Eugene Michael Damico III, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Newark, DE
National Provider Identifier
1386699379
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
G1-0000952 Issued in DE
Practice address
4735 Stanton Ogletwn Rd
Map 2, Ste. 1115
Newark, DE 19713-2072
Phone
(302) 292-1600
Fax
(302) 292-8629
NPI assigned
May 24, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X G1-0000952 DE Primary

Addresses

Primary practice location

4735 Stanton Ogletwn Rd
Map 2, Ste. 1115
Newark, DE 19713-2072

Mailing address

4735 Stanton Ogletwn Rd
Map 2, Ste. 1115
Newark, DE 19713-2072
Phone (302) 292-1600

Other identifiers 4

IdentifierTypeStateIssuer
0000189002MedicaidDE
0116093000OtherAMERIHEALTH
000540991OtherHIGHMARK BLUE SHIELD
4300241OtherAETNA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
G1-0000952DEMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
The Christiana Center for Oral & Maxillofacial Surgery, P.a. Oral and Maxillofacial Surgery Past Accepting new patients
Christiana Center for Oral & Maxillofacial Surgery, P.a. Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 3

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1386699379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 STANTON OGLETWN RD",
            "address_2": "MAP 2, STE. 1115",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132072",
            "telephone_number": "302-292-1600",
            "fax_number": "302-292-8629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 STANTON OGLETWN RD",
            "address_2": "MAP 2, STE. 1115",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132072",
            "telephone_number": "302-292-1600",
            "fax_number": "302-292-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMICO",
        "first_name": "EUGENE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DE",
            "license": "G1-0000952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000189002",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0116093000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "000540991",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4300241",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.