Healthcare Provider Details
I. General information
NPI: 1134045891
Provider Name (Legal Business Name): CAMERON MADSEN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3325 S AVENUE 8 E STE 4
YUMA AZ
85365-8162
US
IV. Provider business mailing address
4080 S SUNLIGHT WAY
YUMA AZ
85365-8431
US
V. Phone/Fax
- Phone: 928-318-6357
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | D012888 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: