Individual provider Active NPI

Melany Camacho, D.D.S

  • Dental Anesthesiology
  • Brooklyn, NY
National Provider Identifier
1578910071
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
License
001199 Issued in NY
Practice address
1428 Dekalb Ave
1F
Brooklyn, NY 11237-3531
Phone
(571) 228-5741
NPI assigned
May 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 058441 NY
Dental Anesthesiology 1223D0004X 001199 NY Primary

Addresses

Primary practice location

1428 Dekalb Ave
1F
Brooklyn, NY 11237-3531

Mailing address

1428 Dekalb Ave
1F
Brooklyn, NY 11237-3531
Phone (571) 228-5741

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160907001698 NY Practitioner - Oral Surgery 7719273366 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
058441NYMDDentist
001199NYMDDentist Anesthesiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Heights Dental Services P.C. Dentist CurrentSince Jul 1, 2016 Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1578910071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 DEKALB AVE",
            "address_2": "1F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373531",
            "telephone_number": "571-228-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 DEKALB AVE",
            "address_2": "1F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373531",
            "telephone_number": "571-228-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "MELANY",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "058441",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "NY",
            "license": "001199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.