Individual provider Active NPI

Cameron Anthony Altadonna, DMD

  • General Practice Dentistry
  • Highland, IL
National Provider Identifier
1538093638
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019037175 Issued in IL
Practice address
1108 Broadway
Highland, IL 62249-1917
Phone
(618) 654-9866
Fax
(618) 654-3099
NPI assigned
Jun 12, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019037175 IL Primary

Addresses

Primary practice location

1108 Broadway
Highland, IL 62249-1917

Mailing address

1108 Broadway
Highland, IL 62249-1917
Phone (618) 654-9866

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

NPI Registry JSON

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

{
    "created_epoch": "1781222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1538093638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 BROADWAY",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491917",
            "telephone_number": "618-654-9866",
            "fax_number": "618-654-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 BROADWAY",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491917",
            "telephone_number": "618-654-9866",
            "fax_number": "618-654-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTADONNA",
        "first_name": "CAMERON",
        "middle_name": "ANTHONY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-12",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019037175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.