Provider Demographics
NPI:1770212656
Name:CAMARGO, JOSEPH DOMINGUES (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DOMINGUES
Last Name:CAMARGO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51300 POMERANTZ FAMILY PAVILION
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1049
Mailing Address - Country:US
Mailing Address - Phone:319-356-2205
Mailing Address - Fax:319-353-6923
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1049
Practice Address - Country:US
Practice Address - Phone:319-356-2205
Practice Address - Fax:319-353-6923
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IARES-306721223S0112X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASTUDENTOtherSTUDENT