Lawrence Jesse Dela Pena Camacho, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

063215 Issued in NY

Practice address

713 Pierce Rd
Clifton Park, NY 12065

Phone

(513) 373-1181

NPI assigned

Mar 25, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dinosaur Orthodontics PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Endicott, NY
  • NPI 1649043910
  NPD

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1821675893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 PIERCE RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "12065",
            "telephone_number": "513-373-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 PIERCE RD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "12065",
            "telephone_number": "513-373-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "LAWRENCE JESSE",
        "middle_name": "DELA PENA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "063215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iftikhar Butt, PA
• Raheela Butt
• Robert Allan Butz Jr., PH.D.
• Randy L Cale, PH.D.
• Caleb a. George & Alan F. Justin
• Jeffrey Stuart Cameron, RPA
• Allison Campbell, LCSWR
• Janay Campbell, LMHC
• Roberta Lynn Canavan, FNP
• Bianca A Cannavo

• Pediatric Dentistry in Clifton Park, NY
• Providers in Clifton Park, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.