Individual provider Active NPI

David Louis Castellano, DMD

  • Dentist
  • Tampa, FL
National Provider Identifier
1205990686
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN15383 Issued in FL
Practice address
12229 W. Linebaugh Ave
Tampa, FL 33626
Phone
(813) 884-4641
Fax
(813) 887-1937
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN15383 FL Primary

Addresses

Primary practice location

12229 W. Linebaugh Ave
Tampa, FL 33626

Mailing address

12229 W. Linebaugh Ave
Tampa, FL 33626
Phone (813) 475-4528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150615001682 FL Order and Referring Only - DentistPractitioner - Dentist 4082925201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
JCDC Dental Inc CurrentSince Apr 17, 2022 Accepting new patients
Palm Harbor Premier Dental, Inc. Dentist Current Accepting new patients

Locations

12229 W Linebaugh Ave
Tampa, FL 33626
Phone (813) 475-4528

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1205990686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12229 W. LINEBAUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33626",
            "telephone_number": "813-475-4528",
            "fax_number": "813-475-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12229 W. LINEBAUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33626",
            "telephone_number": "813-884-4641",
            "fax_number": "813-887-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLANO",
        "first_name": "DAVID",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.