NPIMap

Organization Active NPI

Camelot Endodontics LTD

Doing business as Camelot Endodontics

  • Endodontics
  • Freeport, IL
National Provider Identifier
1336051291
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
CAMELOT ENDODONTICS LTD
Doing business as
Camelot Endodontics
Practice address
1255 W Empire St
Freeport, IL 61032-6100
Phone
(815) 235-1461
NPI assigned
Sep 17, 2026
Last updated
Sep 17, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CAMELOT ENDODONTICS LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Authorized official

Name
Michaela Muniz
Title
VP, Payor Relations
Phone
(469) 324-3242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X NU Primary

Addresses

Primary practice location

1255 W Empire St
Freeport, IL 61032-6100

Mailing address

1255 W Empire St
Freeport, IL 61032-6100
Phone (815) 235-1461

Other names 1

  • Camelot Endodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Camelot Endodontics LTD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1789603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1336051291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W EMPIRE ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326100",
            "telephone_number": "815-235-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W EMPIRE ST",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610326100",
            "telephone_number": "815-235-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT ENDODONTICS LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMELOT ENDODONTICS LTD",
        "enumeration_date": "2026-09-17",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "MUNIZ",
        "authorized_official_first_name": "MICHAELA",
        "authorized_official_title_or_position": "VP, PAYOR RELATIONS",
        "authorized_official_telephone_number": "469-324-3242"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelot Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freeport, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; 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.