Provider Demographics
NPI:1700862810
Name:CAMARATA, JOSEPH CHARLES (MD, DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHARLES
Last Name:CAMARATA
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 S 16TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3796
Mailing Address - Country:US
Mailing Address - Phone:402-435-0044
Mailing Address - Fax:402-435-7010
Practice Address - Street 1:2222 S 16TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3796
Practice Address - Country:US
Practice Address - Phone:402-435-0044
Practice Address - Fax:402-435-7010
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20444174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025237600Medicaid
NE10025237600Medicaid
NEG49454Medicare UPIN