MEDICARE: DANIEL CAMPOS 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	39570	TX
2	1223G0001X	General Practice Dentistry	39570	TX

General Provider Information

NPI Number	:	1881398345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL CAMPOS DDS

Provider Business Mailing Address
First Line	:	17153 LACEBARK LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-6514
Country	:	US
Telephone Number	:	469-879-8161
Fax Number	:

Provider Business Practice Location Address
First Line	:	6108 SKILLMAN ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-7811
Country	:	US
Telephone Number	:	469-998-9822
Fax Number	:

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

Provider Enumeration Date	:	03/29/2023
Last Update Date	:	06/24/2025

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Directions to “ DANIEL CAMPOS DDS” Practice Location

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