Christine Gonzales Castro, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

43121 Issued in CA

Practice address

120 Birmingham Drive
Suite 130
Cardiff by the Sea, CA 92007-1744

Phone

(760) 944-1041

Fax

(760) 944-1074

NPI assigned

Aug 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Christine Castro-Licup Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 15, 2016 through May 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• C. Castro DMD, Inc

  • General Practice Dentistry
  • Cardiff by the Sea, CA
  • NPI 1518367317
  NPD (past) Authorized official

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1235149204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BIRMINGHAM DRIVE",
            "address_2": "SUITE 130",
            "city": "CARDIFF BY THE SEA",
            "state": "CA",
            "postal_code": "920071744",
            "telephone_number": "760-944-1041",
            "fax_number": "760-944-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BIRMINGHAM DRIVE",
            "address_2": "SUITE 130",
            "city": "CARDIFF BY THE SEA",
            "state": "CA",
            "postal_code": "920071744",
            "telephone_number": "760-944-1041",
            "fax_number": "760-944-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "CHRISTINE",
        "middle_name": "GONZALES",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "43132",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "43121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "CASTRO-LICUP",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lyndon Bruce Brown, D.D.S.
• Hayden M Burke, M.D.
• Kristin Butterfield, MPT
• C. Castro DMD, Inc
• Richard Fell Carpenter, NP-C
• Morgan Page Clancy, APCC
• Clearfast, Inc
• Comprehensive Human Services Inc.
• Elissa Rose Dubois, BCBA, M.S
• Daniel Abraham Duel, MD

• Dentist in Cardiff by the Sea, CA
• Providers in Cardiff by the Sea, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.