Individual provider Active NPI

Jose Luis Carcamo, DDS

  • Dentist
  • Boca Raton, FL
National Provider Identifier
1336834720
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DRPM2567 Issued in FL
Practice address
5295 Town Center Rd Ste 2005295
Boca Raton, FL 33486-1080
Phone
(561) 347-8266
NPI assigned
Apr 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DRPM2567 FL Primary

Addresses

Primary practice location

5295 Town Center Rd Ste 2005295
Boca Raton, FL 33486-1080

Mailing address

4502 N Federal Hwy Apt 335D
Lighthouse Point, FL 33064-6795
Phone (954) 740-0186

Other practice location 1

8136 Okeechobee Blvd Ste 200
West Palm Beach, FL 33411-2002
Phone (561) 683-4488

Other practice location 2

2404 Wilton Dr
Wilton Manors, FL 33305-1251
Phone (954) 440-7795

Other practice location 3

2000 NE 44th St Ste 200
Lighthouse Point, FL 33064-7373
Phone (954) 532-6637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DRPM2567FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Associates, Inc PastSince Apr 1, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1336834720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 N FEDERAL HWY APT 335D",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330646795",
            "telephone_number": "954-740-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5295 TOWN CENTER RD STE 2005295",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334861080",
            "telephone_number": "561-347-8266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8136 Okeechobee Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334112002",
            "country_code": "US",
            "telephone_number": "561-683-4488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2404 Wilton Dr",
            "address_purpose": "LOCATION",
            "city": "Wilton Manors",
            "state": "FL",
            "postal_code": "333051251",
            "country_code": "US",
            "telephone_number": "954-440-7795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 NE 44th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lighthouse Point",
            "state": "FL",
            "postal_code": "330647373",
            "country_code": "US",
            "telephone_number": "954-532-6637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARCAMO",
        "first_name": "JOSE",
        "middle_name": "LUIS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-10",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DRPM2567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.