Fredy Cam-Koo, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

6001596-15 Issued in WI

Practice address

8200 W Silver Spring Dr
Milwaukee, WI 53218-2552

Phone

(414) 760-3900

Fax

(414) 464-7258

NPI assigned

Jun 28, 2024

Last updated

Jul 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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 WI

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fcamkoo728469@direct.ochin.org
• Direct secure messaging: fcamkoo826115@direct.ochin.org

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.

• Milwaukee Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1518005818
  Medicare reassignment NPD
• Milwaukee Health Services Inc

  dba Martin Luther King Heritage Health Center

  • Case Management Agency
  • Milwaukee, WI
  • NPI 1346657442
  NPD
• Milwaukee Health Services, Inc.

  dba Isaac Coggs Heritage Health Center

  • Clinic Pharmacy
  • Milwaukee, WI
  • NPI 1376570663
  NPD

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1952146144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 N DR MARTIN LUTHER KING JR DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122709",
            "telephone_number": "414-267-6641",
            "fax_number": "414-372-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 W SILVER SPRING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532182552",
            "telephone_number": "414-760-3900",
            "fax_number": "414-464-7258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2555 N Dr Martin Luther King Jr Dr",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532122709",
            "country_code": "US",
            "telephone_number": "414-372-8080",
            "fax_number": "414-562-8432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAM-KOO",
        "first_name": "FREDY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001596-15",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6001596-15",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100282351",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward P Callahan, MD
• Brandon Calley, MD
• Debbie A Callif, OT
• Calso Transportation
• Andrew W Calvert, MD
• Jacqueline Camacho
• Margo J Camacho, LPC
• Alhaji Camara
• Dawn Marie Camara, M.S./CCC-SLP
• Damon R Camarata, LCSW

• Dentist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.