Cameron John Elmer, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6970 Issued in IA

Practice address

104 N Walnut St
West Union, IA 52175-1347

Phone

(563) 422-5629

NPI assigned

Nov 15, 2006

Last updated

Jul 8, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417029208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N WALNUT ST",
            "address_2": "PO BOX478",
            "city": "WEST UNION",
            "state": "IA",
            "postal_code": "521751347",
            "telephone_number": "563-422-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N WALNUT ST",
            "city": "WEST UNION",
            "state": "IA",
            "postal_code": "521751347",
            "telephone_number": "563-422-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMER",
        "first_name": "CAMERON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1217299",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reed J Davis, CRNA
• Ciera Deitchler
• Andrea Kaye Dietzenbach, P.A.
• Marin Ehler, DPT
• Eickert Chiropractic Clinic PLLC (west union chiropractic clinic)
• Fayette County Case Management
• Gabrielle Icele Flynt, DNP, CNP, ACNPC-AG
• Keisha Formanek, COTA/L
• Jennifer Brekke Fuentes, PT
• Garvin Moser LLC (Stoney Brook Village)

• General Practice Dentistry in West Union, IA
• Providers in West Union, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.