Camilo Machado, DDS, MS

Primary specialty

DentistTaxonomy code 122300000X

License

1710025499 Issued in MI

Practice address

31315 Harper Avenuw
St. Clair Shores, MI 48082

Phone

(586) 293-3434

Fax

(586) 293-4460

NPI assigned

Feb 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ez Dentists PLC

  • Dental Clinic/Center
  • Dearborn Heights, MI
  • NPI 1366109787
  NPD Authorized official
• Oval Dental Group P C

  • Dentist
  • Westland, MI
  • NPI 1629536388
  NPD Authorized official
• Alpha Family Dental PC

  • Dental Clinic/Center
  • Saint Clair Shores, MI
  • NPI 1083015317
  NPD (past) Authorized official

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1710025499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31315 HARPER AVENUE",
            "city": "ST. CLAIR SHORES",
            "state": "MI",
            "postal_code": "48082",
            "telephone_number": "586-293-3434",
            "fax_number": "614-292-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31315 HARPER AVENUW",
            "city": "ST. CLAIR SHORES",
            "state": "MI",
            "postal_code": "48082",
            "telephone_number": "586-293-3434",
            "fax_number": "586-293-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHADO",
        "first_name": "CAMILO",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "OH",
            "license": "71-000189",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "1710025499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO STATE LICENSE NUMBER",
            "identifier": "71000189",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luxottica Retail North America Inc (Lenscrafters #05572)
• Christine R Luzadas, PHYSICAL THERAPIST
• Krysta Lynn
• Kianna Michelle Lyons, NP
• Michael Maceroni
• Gregory M Macisak
• Megan Maclean
• Olivia Macphee
• Madhav Pharmacy LLC (Lakewood Pharmacy)
• Alyssa Madison, DPT

• Dentist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.