Campo Elias Perez, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

RFD000029 Issued in PA

Practice address

240 S 40TH St
Philadelphia, PA 19104-6030

Phone

(215) 898-8965

NPI assigned

Sep 30, 2008

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

Medicare fee-for-service enrollment

Enrolled in MA

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

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1821248584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LOCUST ST APT 2604",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024339",
            "telephone_number": "617-320-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S 40TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191046030",
            "telephone_number": "215-898-8965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "269 Union St",
            "address_purpose": "LOCATION",
            "city": "Lynn",
            "state": "MA",
            "postal_code": "019011314",
            "country_code": "US",
            "telephone_number": "781-581-9832",
            "fax_number": "781-581-9583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CAMPO",
        "middle_name": "ELIAS",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-30",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "10395",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "RFD000029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alysia Victoria Perez
• Amanda Estrellita Perez
• Amanda Luz Perez
• Biany Perez, M.ED., MSS, LSW
• Bryan Michael Perez, MD
• Carlos Andres Perez, MD
• Carlos J Perez, MD PHD
• Catherine Perez, MS, RD
• Catherine Eusebio Perez, RN
• Daniel A. Perez, MD

• Periodontics in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Periodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.