Individual provider Active NPI

Lliliam Castellanos-Castro, DDS

  • General Practice Dentistry
  • San Antonio, TX
National Provider Identifier
1053804476
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
34188 Issued in TX
Practice address
3066 E Commerce St
San Antonio, TX 78220-1013
Phone
(210) 233-7000
NPI assigned
Jun 11, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 34188 TX Primary

Addresses

Primary practice location

3066 E Commerce St
San Antonio, TX 78220-1013

Mailing address

PO Box 2325
Universal City, TX 78148-1325
Phone (210) 233-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230418002230 TX Practitioner - Dentist 5597130815 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34188TXMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Apr 6, 2023 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Apr 6, 2023 Accepting new patients
Campos Family Dental. P.C, General Practice Past Accepting new patients

Locations

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

Interoperability endpoints

  • Direct secure messaging: lliliam.castellanoscastro@commsa.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1053804476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2325",
            "city": "UNIVERSAL CITY",
            "state": "TX",
            "postal_code": "781481325",
            "telephone_number": "210-233-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLANOS-CASTRO",
        "first_name": "LLILIAM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.