NPIMap

Organization Active NPI

Optimum Dental Care, CSP

  • Pediatric Dentistry
  • Guaynabo, PR
National Provider Identifier
1285878587
Registry record updated Apr 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2239 Issued in PR
Legal business name
OPTIMUM DENTAL CARE, CSP
Practice address
107 Ave Ortegon Ste 202
Caparra Gallery Building
Guaynabo, PR 00966-2517
Phone
(787) 783-6698
Fax
(787) 793-3105
NPI assigned
Apr 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2009

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

Authorized official

Name
Dr. Ithamar Castro, DMDNPI 1447309273
Title
Dentist
Phone
(787) 783-6698

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
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 2239 PR Primary

Addresses

Primary practice location

107 Ave Ortegon Ste 202
Caparra Gallery Building
Guaynabo, PR 00966-2517

Mailing address

107 Ave Ortegon Ste 202
Caparra Gallery Building
Guaynabo, PR 00966-2517
Phone (787) 783-6698

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1241049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241049600000",
    "number": "1285878587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 AVE ORTEGON STE 202",
            "address_2": "CAPARRA GALLERY BUILDING",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662517",
            "telephone_number": "787-783-6698",
            "fax_number": "787-793-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 AVE ORTEGON STE 202",
            "address_2": "CAPARRA GALLERY BUILDING",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662517",
            "telephone_number": "787-783-6698",
            "fax_number": "787-793-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM DENTAL CARE, CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-30",
        "last_updated": "2009-04-30",
        "status": "A",
        "authorized_official_last_name": "CASTRO",
        "authorized_official_first_name": "ITHAMAR",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "787-783-6698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PR",
            "license": "2239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.