Jason Ryan Campbell, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

009713 Issued in CT

Practice address

67 Lafayette St
Norwich, CT 06360

Phone

(860) 889-5213

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Lafayette Dental Group, PC

  • General Practice Dentistry
  • Norwich, CT
  • NPI 1699811075
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1639257306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 MCDONALD RD",
            "city": "COLCHESTER",
            "state": "CT",
            "postal_code": "06415",
            "telephone_number": "734-945-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 LAFAYETTE ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-889-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JASON",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18583",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria J Cameron, MSW LCSW
• Jacqueline R Cameron, M.D.
• Megan Cameron, LMFT
• Carol Jean Campbell, LMFT
• Cynthia Lynn Campbell, M.D.
• Margery Lee Canfield, LCSW
• Kathleen M. Cannon, ND
• Melissa Cantave
• Iesha O Canty
• Barclay G Caras, MD

• General Practice Dentistry in Norwich, CT
• Providers in Norwich, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.