Camille Suzette San Miguel, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

061259 Issued in NY

Practice address

8708 Woodhaven Blvd
Woodhaven, NY 11421-2284

Phone

(718) 805-7777

NPI assigned

Feb 1, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Manhattan Park Dental, PLLC

  • General Practice Dentistry
  • New York, NY
  • NPI 1720888910

  Pediatric Dentistry

  NPD Authorized official

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1477051787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 CATHERINE ST APT 5C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100381049",
            "telephone_number": "240-491-7171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8708 WOODHAVEN BLVD",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212284",
            "telephone_number": "718-805-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAN MIGUEL",
        "first_name": "CAMILLE",
        "middle_name": "SUZETTE",
        "name_prefix": "Miss",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "061259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheby Yen Lim Ruiz, PT
• Kathy Ryan, R.N.
• Ryu Chiropractic PLLC
• Sadyribeiro Pain Management and Medical Services PC
• Richard C Saline, DMD
• San Pedro Claver Pharmacy Inc.
• Aaron Sanchez, MSW
• Yolanda Sanchez, MSED
• Benesa Santos, LMT
• Saumil Patel DDS PC

• Pediatric Dentistry in Woodhaven, NY
• Providers in Woodhaven, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.