MEDICARE: DR. RICHARD P. CAMPBELL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	10782	MD
2	1223G0001X	General Practice Dentistry	0401008125	VA

General Provider Information

NPI Number	:	1720064611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD P. CAMPBELL DDS

Provider Business Mailing Address
First Line	:	250 MAKALAPA DR
Second Line	:	ATTN: PROFESSIONAL AFFAIRS COORDINATOR (N01HD)
City	:	PEARL HARBOR
State	:	HI
Zip	:	96860-3131
Country	:	US
Telephone Number	:	808-471-2463
Fax Number	:

Provider Business Practice Location Address
First Line	:	USS ABRAHAM LINCOLN (CVN 72)
Second Line	:
City	:	FPO
State	:	AP
Zip	:	96612-2872
Country	:	US
Telephone Number	:	425-304-5092
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	09/11/2025

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