NPIMap

Organization Active NPI

Eric R.Castillo DDS, P.C.

  • Dentist
  • Ardmore, OK
National Provider Identifier
1245612936
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5652 Issued in OK
Legal business name
ERIC R.CASTILLO DDS, P.C.
Practice address
1110 Walnut Dr
Ardmore, OK 73401-2353
Phone
(580) 223-7779
Fax
(580) 223-7789
NPI assigned
Jun 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Authorized official

Name
Dr. Eric R. Castillo, DDSNPI 1649356569
Title
Owner/President
Phone
(580) 223-7779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 5652 OK Primary

Addresses

Primary practice location

1110 Walnut Dr
Ardmore, OK 73401-2353

Mailing address

1110 Walnut Dr
Ardmore, OK 73401-2353
Phone (580) 223-7779

Other identifiers 1

IdentifierTypeStateIssuer
200021060AMedicaidOK

Other names 1

  • Castillo Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1110 Walnut Dr
Ardmore, OK 73401
Phone (580) 223-7779

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1245612936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012353",
            "telephone_number": "580-223-7779",
            "fax_number": "580-223-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 WALNUT DR",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734012353",
            "telephone_number": "580-223-7779",
            "fax_number": "580-223-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC R.CASTILLO DDS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "580-223-7779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "5652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200021060A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Castillo Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.