Basic Information
Provider Information
NPI: 1508917188
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FALCON-CAMACHO
FirstName: CARLOS
MiddleName: R.
NamePrefix: DR.
NameSuffix:  
Credential: D.M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: RIACHUELO
Address2: RO-14 CORRIENTES ST.
City: TRUJILLO ALTO
State: PR
PostalCode: 00976
CountryCode: US
TelephoneNumber: 7877613447
FaxNumber:  
Practice Location
Address1: CENTRO DE EPIDEMIOLOGA DE BAYAMN
Address2: CALLE ISABEL II ESQ CALLE DEGETAU
City: BAYAMON
State: PR
PostalCode: 00960
CountryCode: US
TelephoneNumber: 7877982964
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/12/2007
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X2229PRY Dental ProvidersDentist 

No ID Information.


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