Individual provider Active NPI

Dewayne B McCamish, D.D.S., M.S., P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chattanooga, TN
National Provider Identifier
1902889975
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
TN102208 Issued in TN
Practice address
4610 Brainerd Rd
Suite 3
Chattanooga, TN 37411-3835
Phone
(423) 624-6425
Fax
(423) 629-9889
NPI assigned
Nov 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X TN102208 TN Primary

Addresses

Primary practice location

4610 Brainerd Rd
Suite 3
Chattanooga, TN 37411-3835

Mailing address

4610 Brainerd Rd
Suite 3
Chattanooga, TN 37411-3835
Phone (423) 624-6425

Other identifiers 1

IdentifierTypeStateIssuer
0016229MedicaidTN

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
TN102208TNMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Dentistry and Orthodontics of Chattanooga Orthodontics and Dentofacial Orthopedics 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.

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1902889975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 BRAINERD RD",
            "address_2": "SUITE 3",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113835",
            "telephone_number": "423-624-6425",
            "fax_number": "423-629-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 BRAINERD RD",
            "address_2": "SUITE 3",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113835",
            "telephone_number": "423-624-6425",
            "fax_number": "423-629-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAMISH",
        "first_name": "DEWAYNE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S., P.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "TN102208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016229",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.