Individual provider Active NPI

Josef Camello Doctor, DDS

  • General Practice Dentistry
  • Frankfort, IL
National Provider Identifier
1669595690
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
10065 W Lincoln Hwy
Presidents Row Office Park Josef C Doctor DDS
Frankfort, IL 60423
Phone
(815) 469-0707
Fax
(815) 469-0704
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

10065 W Lincoln Hwy
Presidents Row Office Park Josef C Doctor DDS
Frankfort, IL 60423

Mailing address

10065 W Lincoln Hwy
Presidents Row Office Park Josef C Doctor DDS
Frankfort, IL 60423
Phone (815) 469-0707

Other identifiers 1

IdentifierTypeStateIssuer
101529OtherPAYEE ID FOR DORAL DENTAL

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
019020721ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669595690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10065 W LINCOLN HWY",
            "address_2": "PRESIDENTS ROW OFFICE PARK JOSEF C DOCTOR DDS",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "60423",
            "telephone_number": "815-469-0707",
            "fax_number": "815-469-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10065 W LINCOLN HWY",
            "address_2": "PRESIDENTS ROW OFFICE PARK JOSEF C DOCTOR DDS",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "60423",
            "telephone_number": "815-469-0707",
            "fax_number": "815-469-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCTOR",
        "first_name": "JOSEF",
        "middle_name": "CAMELLO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PAYEE ID FOR DORAL DENTAL",
            "identifier": "101529",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.