Active NPI
Laura Lynn Dameron, DMD
- General Practice Dentistry
- Canton, GA
National Provider Identifier
1790790103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 011695
- Practice address
- 6199 Hickory Flat Hwy
Suite 130
Canton, GA 30115-7255 - Phone
- (770) 345-8646
- NPI assigned
- Jul 31, 2006
- Sex
- Female
- 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 | 011695 | GA | Primary |
Addresses
Primary practice location
6199 Hickory Flat Hwy
Suite 130
Canton, GA 30115-7255
Mailing address
6199 Hickory Flat Hwy
Suite 130
Canton, GA 30115-7255
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 |
|---|---|---|---|
| 011695 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dameron Family Dentistry | General Practice | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Canton, GA
- NPI 1063427474
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790790103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6199 HICKORY FLAT HWY",
"address_2": "SUITE 130",
"city": "CANTON",
"state": "GA",
"postal_code": "301157255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6199 HICKORY FLAT HWY",
"address_2": "SUITE 130",
"city": "CANTON",
"state": "GA",
"postal_code": "301157255",
"telephone_number": "770-345-8646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMERON",
"first_name": "LAURA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "011695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- 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.