Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Luis Pedro Miron Carcamo

Individual provider General Practice Dentistry · NPI 1962790006

Dr. Luis Pedro Miron Carcamo is a General Practice Dentistry in Champaign, Illinois. Works from 4 locations. Licensed in Illinois and Washington.

Licensed in
IL, WA
In the registry since
2011
Specialties on file
2
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Practice location Address checks out

1701 S Prospect Ave Ste 201
Champaign, IL 61820-7054
Phone: (217) 305-7980
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 1051 Columbia Ave, Connell, WA 99326-8702 — (509) 488-5256
  • 601 Government Rd, Mattawa, WA 99349-5120 — (509) 488-5256
  • 1515 E Columbia St, Othello, WA 99344-1846 — (509) 488-5256

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 019030115 (IL)
General Practice Dentistry Taxonomy 1223G0001X · Licence DE60448654 (WA)

Record details

NPI number1962790006
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 11, 2011
Last updated in NPPESOctober 16, 2024
Certification dateOctober 16, 2024

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