Luis M. Camacho, D.M.D.

Individual provider Active NPI General Practice Dentistry · Yauco, PR

NPI 1992808984 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992808984
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2307 (PR)
Practice address
68 Calle Comercio
Yauco, PR 00698-3530
Phone
(787) 856-6292
Fax
(787) 856-4464
NPI assigned
Sep 6, 2006
Sex
Male
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 IDStateProvider typePAC IDDetails
I20160205000740 PR Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
1153625595

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2307PRMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2307 PR Yes

Addresses

Primary practice location

68 Calle Comercio
Yauco, PR 00698-3530

Mailing address

PO Box 192
Guanica, PR 00653-0192
Phone (787) 856-1174

Other providers in Yauco, PR

All providers in Yauco, PR · General Practice Dentistry in Puerto Rico

Sources for this page

Verify at the official NPI Registry.