Myrna E Camacho, DMD
Individual provider Active NPI Dentist · Guaynabo, PR
NPI 1912208166 · NPPES record last updated Feb 16, 2021
Key facts
- NPI
- 1912208166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2865 (PR)
- Practice address
- 81 Ave Esmeralda
Guaynabo, PR 00969-4429 - Phone
- (787) 485-4804
- NPI assigned
- Nov 4, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210316002780 | PR | Order and Referring Only - Dentist |
4082020003 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2865 | PR | Yes |
Addresses
Primary practice location
81 Ave Esmeralda
Guaynabo, PR 00969-4429
Mailing address
PO Box 3431
Guaynabo, PR 00970-3431
Phone (787) 485-4804
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2865 | Other | PR | DENTAL LISCENCE |
Other providers in Guaynabo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.