Provider Demographics
NPI:1841275997
Name:CAMAISA, TED JAMIR (DDS)
Entity type:Individual
Prefix:DR
First Name:TED
Middle Name:JAMIR
Last Name:CAMAISA
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:BDC PORT HUENEME
Mailing Address - Street 2:720 23RD AVE. BLDG 914
Mailing Address - City:PORT HUENEME
Mailing Address - State:CA
Mailing Address - Zip Code:93043-7312
Mailing Address - Country:US
Mailing Address - Phone:805-982-5911
Mailing Address - Fax:
Practice Address - Street 1:BDC PORT HUENEME
Practice Address - Street 2:720 23RD AVE. BLDG 914
Practice Address - City:PORT HUENEME
Practice Address - State:CA
Practice Address - Zip Code:93043-7312
Practice Address - Country:US
Practice Address - Phone:805-982-5911
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA375361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice