Cameron Weaver Blyth, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

D008312 Issued in AZ

Practice address

22211 South Elsworth Rd
Queen Creek, AZ 85142

Phone

(480) 214-5530

NPI assigned

Aug 19, 2011

Sex

Male

Sole proprietor

No

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 and National Provider Directory roles.

• Aesthetic Smiles of Queen Creek

  • Dental Clinic/Center
  • Queen Creek, AZ
  • NPI 1013793785
  NPD Authorized official

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313712000000",
    "number": "1396025573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 E SOUTHERN AVE UNIT 215",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045511",
            "telephone_number": "480-652-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22211 SOUTH ELSWORTH RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "85142",
            "telephone_number": "480-214-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLYTH",
        "first_name": "CAMERON",
        "middle_name": "WEAVER",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D008312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Birch Tree Pediatric Dentistry PLLC
• Kendree Brinae Bitter, MAS-LAMFT
• Paul N Black, ED.S.
• Jacqueline Blanch, APRN
• Audrey Blanchette
• Leslie Boag, MSW, LCSW
• Patience Boateng, BHT
• Stacey Bonenberger
• Botanical Protection LLC
• Botanical Protection LLC

• Dentist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.