NPIMap

Organization Active NPI

Glen T. Casto DDS,MDS,PA

  • Endodontics
  • Sebastian, FL
National Provider Identifier
1245521228
Registry record updated Apr 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN16640 Issued in FL
Legal business name
GLEN T. CASTO DDS,MDS,PA
Practice address
621 Sebastian Boulevard
Suite B
Sebastian, FL 32958
Phone
(772) 388-6400
Fax
(772) 388-6446
NPI assigned
Apr 26, 2011
Last updated
Apr 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2011

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

Authorized official

Name
Mrs. Tanya Poppell
Title
Manager
Phone
(772) 388-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN16640 FL Primary

Addresses

Primary practice location

621 Sebastian Boulevard
Suite B
Sebastian, FL 32958

Mailing address

621 Sebastian Blvd
Suite B
Sebastian, FL 32958-4309
Phone (772) 388-6400

National Provider Directory

National Provider Directory
Tax ID family
Glen T Casto DDS MDS PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1245521228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 SEBASTIAN BLVD",
            "address_2": "SUITE B",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329584309",
            "telephone_number": "772-388-6400",
            "fax_number": "772-388-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SEBASTIAN BOULEVARD",
            "address_2": "SUITE B",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "32958",
            "telephone_number": "772-388-6400",
            "fax_number": "772-388-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN T. CASTO DDS,MDS,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-26",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "POPPELL",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "772-388-6400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN16640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; 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.