Jessica Castro
Individual provider Active NPI Dental Assistant · Eielson Afb, AK
NPI 1265016273 · NPPES record last updated May 6, 2021
Key facts
- NPI
- 1265016273
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Assistant 126800000X
- Practice address
- 2630 Central Ave
Eielson Afb, AK 99702-2301 - Phone
- (907) 377-6767
- NPI assigned
- May 6, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Yes |
Addresses
Primary practice location
2630 Central Ave
Eielson Afb, AK 99702-2301
Mailing address
2630 Central Ave
Eielson Afb, AK 99702-2301
Phone (907) 377-6767
Other providers in Eielson Afb, AK
- Dayne Kawika Bonzo
- Daniel Braswell
- Kelsey Gene Broome
- Angelia Deanne Calder
- Gretchen Kay Casci
- Jolanda Jeanette Cook
- Matthew Gray Corbin
- Samuel Wade Cuidon
- Melanie Marie Cusi
- Jamie Yvonne Custodio
All providers in Eielson Afb, AK · Dental Assistant in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.