Active NPI
Damien William Nelson, DDS
- General Practice Dentistry
- Lackland Afb, TX
National Provider Identifier
1659965770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1002658-15
- Practice address
- 2133 Pepperrell St BLDG 3352
Lackland Afb, TX 78236-5313 - Phone
- (210) 292-6258
- NPI assigned
- Mar 1, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1002658-15 | WI | Primary |
Addresses
Primary practice location
2133 Pepperrell St BLDG 3352
Lackland Afb, TX 78236-5313
Mailing address
28130 N Darrell Rd
Wauconda, IL 60084-9723
Phone (773) 615-0133
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | damien.w.nelson.mil@mail.mil | Direct | |
| Direct Messaging Address | damien.w.nelson.mil@health.mil | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1002658-15 | WI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752451200000",
"number": "1659965770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28130 N DARRELL RD",
"city": "WAUCONDA",
"state": "IL",
"postal_code": "600849723",
"telephone_number": "773-615-0133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2133 PEPPERRELL ST BLDG 3352",
"city": "LACKLAND AFB",
"state": "TX",
"postal_code": "782365313",
"telephone_number": "210-292-6258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "DAMIEN",
"middle_name": "WILLIAM",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-03-01",
"last_updated": "2025-07-14",
"certification_date": "2025-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "1002658-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "damien.w.nelson.mil@mail.mil",
"affiliation": "N",
"endpointDescription": "Schriever Medical Clinic",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "220 Falcon Pkwy",
"city": "Schriever AFB",
"state": "CO",
"country_code": "US",
"postal_code": "809125005",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "damien.w.nelson.mil@health.mil",
"affiliation": "N",
"endpointDescription": "Air Force Post-Graduate Dental School",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2133 Pepperrell St Bldg 3352",
"city": "Lackland AFB",
"state": "TX",
"country_code": "US",
"postal_code": "782365313",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lackland Afb, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.