Provider Demographics
NPI:1275100315
Name:AITKEN, CAMERON MATHIAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:MATHIAS
Last Name:AITKEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 J ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-1643
Mailing Address - Country:US
Mailing Address - Phone:402-733-3612
Mailing Address - Fax:
Practice Address - Street 1:1800 SYRACUSE AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-2458
Practice Address - Country:US
Practice Address - Phone:402-371-8780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD13071223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health