Provider Demographics
NPI:1366545808
Name:CAMPO, APOSINDA SR (DDS)
Entity type:Individual
Prefix:MRS
First Name:APOSINDA
Middle Name:
Last Name:CAMPO
Suffix:SR
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:APOSINDA
Other - Middle Name:
Other - Last Name:CAMPO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:8 W MERRICK RD
Mailing Address - Street 2:# 207
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520
Mailing Address - Country:US
Mailing Address - Phone:516-867-2400
Mailing Address - Fax:516-546-3253
Practice Address - Street 1:8 W MERRICK RD
Practice Address - Street 2:# 207
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520
Practice Address - Country:US
Practice Address - Phone:516-867-2400
Practice Address - Fax:516-546-3253
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0306021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00293898Medicaid