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DR. CARLOS ERNESTO CAMPODONICO DDS
NPI 1154546877
Dentist - General Practice in Blaine, MN

Active since April 16, 2007PECOS Enrolled
11806 ABERDEEN ST NE STE 150, BLAINE, MN 55449(763) 786-1545(763) 786-2939 Get Directions Write a Review

NPPES record last updated: August 2, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Carlos Ernesto Campodonico Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CARLOS ERNESTO CAMPODONICO DDS (NPI 1154546877) is an individual general practice provider in Blaine, Minnesota, licensed in Minnesota (D12159) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154546877
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. CARLOS ERNESTO CAMPODONICOCredential: DDS
Location Address11806 ABERDEEN ST NE STE 150Blaine, MN 55449-4748
Mailing Address11806 Aberdeen St Ne Ste 150Blaine, MN 55449-4748 · (763) 786-1545 · Fax (763) 786-2939
Phone(763) 786-1545
Fax(763) 786-2939
Sole ProprietorNo
Enumeration DateApril 16, 2007
Last NPPES UpdateAugust 2, 2016
✔ NPI 1154546877 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MN · D12159
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
11806 ABERDEEN ST NE STE 150, Blaine, MN 55449
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Other Identifiers 1

Medicaid767695000MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Carlos Ernesto Campodonico Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55449 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carlos Campodonico's NPI number?

The NPI number for Carlos Campodonico is 1154546877. It was assigned to this individual provider in the NPPES registry on April 16, 2007.

Where is Carlos Campodonico located?

Carlos Campodonico practices at 11806 Aberdeen St NE Ste 150, Blaine, MN 55449. The listed phone number is (763) 786-1545.

What is Carlos Campodonico's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Carlos Campodonico enrolled in Medicare?

Yes. Carlos Campodonico is registered in the Medicare PECOS enrollment system.

What insurance does Carlos Campodonico accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Carlos Campodonico as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carlos Campodonico was last updated on August 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.