Individual provider Active NPI

Cameron Baker Watson, D.M.D.

  • Dentist
  • Marietta, GA
National Provider Identifier
1508949280
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN012565 Issued in GA
Practice address
1808 Powder Springs Rd SW
Marietta, GA 30064-4150
Phone
(770) 941-6979
Fax
(770) 732-6292
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN012565 GA Primary

Addresses

Primary practice location

1808 Powder Springs Rd SW
Marietta, GA 30064-4150

Mailing address

1808 Powder Springs Rd SW
Marietta, GA 30064-4150
Phone (770) 941-6979

Other practice location 1

4690 Woodstock Rd
Roswell, GA 30075-2089
Phone (770) 628-5647

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN012565GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Wellness Dentistry CurrentSince May 11, 2025 Accepting new patients

Locations

4690 Woodstock Rd
Roswell, GA 30075
Phone (770) 628-5647

4690 Woodstock Rd
Ste 100
Roswell, GA 30075
Phone (770) 992-6568

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1508949280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 POWDER SPRINGS RD SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644150",
            "telephone_number": "770-941-6979",
            "fax_number": "770-732-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 POWDER SPRINGS RD SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644150",
            "telephone_number": "770-941-6979",
            "fax_number": "770-732-6292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4690 Woodstock Rd",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300752089",
            "country_code": "US",
            "telephone_number": "770-628-5647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "CAMERON",
        "middle_name": "BAKER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN012565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

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