Provider Demographics
NPI:1215449277
Name:CAMPOS, HAYDEE MOJICA (DDS, BS)
Entity type:Individual
Prefix:DR
First Name:HAYDEE
Middle Name:MOJICA
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:DDS, BS
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:14 LAPHAM WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-4537
Mailing Address - Country:US
Mailing Address - Phone:415-577-4358
Mailing Address - Fax:
Practice Address - Street 1:3580 CALIFORNIA ST STE 204
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1717
Practice Address - Country:US
Practice Address - Phone:415-563-2022
Practice Address - Fax:844-863-1211
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA446141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice