Active NPI
Guillermo J Camacho, DDS
- Dentist
- West Covina, CA
National Provider Identifier
1669647491
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 45094
- Practice address
- 1042 W West Covina Pkwy
West Covina, CA 91790-2810 - Phone
- (626) 960-2766
- Fax
- (626) 962-8216
- NPI assigned
- Apr 23, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 45094 | CA | Primary |
Addresses
Primary practice location
1042 W West Covina Pkwy
West Covina, CA 91790-2810
Mailing address
1042 W West Covina Pkwy
West Covina, CA 91790-2810
Phone (626) 960-2766
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208908800000",
"number": "1669647491",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1042 W WEST COVINA PKWY",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902810",
"telephone_number": "626-960-2766",
"fax_number": "626-962-8216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1042 W WEST COVINA PKWY",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917902810",
"telephone_number": "626-960-2766",
"fax_number": "626-962-8216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMACHO",
"first_name": "GUILLERMO",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-23",
"last_updated": "2008-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "45094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.