Richard E Castro, D.D.S.
Individual provider Active NPI General Practice Dentistry · Beaverton, OR
NPI 1285658443 · NPPES record last updated Jul 12, 2007
Key facts
- NPI
- 1285658443
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D6770 (OR)
- Practice address
- 4855 SW Western Ave
Beaverton, OR 97005-3460 - Phone
- (503) 626-4148
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110718000475 | OR | Order and Referring Only - Oral Surgery |
1850569823 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D6770 | OR | Yes |
Addresses
Primary practice location
4855 SW Western Ave
Beaverton, OR 97005-3460
Mailing address
4855 SW Western Ave
Beaverton, OR 97005-3460
Phone (503) 626-4148
NPI Registry JSON
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1285658443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4855 SW WESTERN AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970053460",
"telephone_number": "503-626-4148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4855 SW WESTERN AVE",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970053460",
"telephone_number": "503-626-4148"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTRO",
"first_name": "RICHARD",
"middle_name": "E",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D6770",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
- Desiree Castillo
- Maria L Castillo
- Summer Layne Castle
- David Castleton
- Kailey Brianne Castro
- Carlo Magno Donor Catabijan
- Catalyst Chiropractic and Rehabilitation PC
- Nadege Vaimiti Cates
- Catherine B. Kim, DMD, L.L.C.
- Sydney Cathersal
All providers in Beaverton, OR · General Practice Dentistry in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.