Gracie Castillo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

102077 Issued in CA

Practice address

4277 W El Segundo Blvd
Hawthorne, CA 90250-4548

Phone

(310) 970-0200

NPI assigned

Nov 14, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1013420967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 GOSHEN AVE APT 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496379",
            "telephone_number": "831-840-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4277 W EL SEGUNDO BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902504548",
            "telephone_number": "310-970-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "GRACIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "102077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dulce Cardenas, CMT
• Patricia L Carnival, MPT, OCS
• Norma Ivette Cartagena
• Travestine Lenette Casey
• Celena Castillo
• Michelle Castillo
• Simone A Cato-Jack
• Chanelle Jesnine Catuogno
• Roselyn Cayan
• Cecille Ho DDS, Inc

• General Practice Dentistry in Hawthorne, CA
• Providers in Hawthorne, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.