MEDICARE: DR. RANDON 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	122300000X	Dentist	DN25818	FL
2	122300000X	Dentist	DN122386	GA

General Provider Information

NPI Number	:	1710565148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RANDON CAMPBELL DDS

Provider Business Mailing Address
First Line	:	6480 SW 27TH ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-3816
Country	:	US
Telephone Number	:	305-954-1751
Fax Number	:

Provider Business Practice Location Address
First Line	:	6169 S JOG RD UNIT A8-A9
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33467-6579
Country	:	US
Telephone Number	:	305-954-1751
Fax Number	:

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

Provider Enumeration Date	:	03/29/2021
Last Update Date	:	04/09/2026

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