John H Campbell IV, DDS, MS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0360221 Issued in NY

Practice address

3435 Main St, 119 Squire Hall
Buffalo, NY 14214

Phone

(716) 829-6637

Fax

(716) 829-3019

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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.

• Indiana University

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1689790552

  Oral and Maxillofacial Surgery

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 15, 2020.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1194768630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 MAIN ST",
            "address_2": "119 SQUIRE HALL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142143001",
            "telephone_number": "716-829-6637",
            "fax_number": "716-829-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 MAIN ST, 119 SQUIRE HALL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14214",
            "telephone_number": "716-829-6637",
            "fax_number": "716-829-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "036022",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "0360221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01151064",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Ann Campanelli
• Hope Campanie
• Sheryl Antoinette Campbell-Julien, PMHNP
• Christina Campbell, PTA
• Davina Campbell, LPN
• Kendra Y Campbell, RN
• Laurie Ann Campbell, NP
• Lucy A Campbell, MD
• Marisa Danette Campbell, MSW
• Marita T Campbell, LCSWR

• All providers in Buffalo, NY
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.