NPI age
13 years
Enumerated 2012-09-19
● Active
Type 1 · Individual
DR. Damaris Derece Bastian, D.D.S.
Bastian is 1 of 48 dentist providers in Fayetteville and 1 of 4309 in Georgia.
Primary specialty
Dentist
Plus 1 subspecialty
Licensed in
GA, LA
2 states
Status
Active
No deactivations on record
Last NPPES update
2021-11-08
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 4309 active dentist providers in Georgia.
NPI age
13 years
↓ 5 yr below median (18 yr)
State licenses
2 states
Top 93% — 6% of peers are multi-state
Subspecialties
0
13% of peers hold subspecialties
NPI lifetime · 2012 → 2026
2012-09Enumerated in NPPES
2012
2026
Where they practice
Practice location
101 Devant St Ste 404
Fayetteville, GA 302142713
Mailing address
101 Devant St Ste 404
Fayetteville, GA 302142713
Specialties
-
Dentist PrimaryA general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (LA) | 1850870 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
Recently enumerated nearby: 1 new dentist provider has been added in Fayetteville in the last 180 days.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.