Individual provider Active NPI

Elsa Castro, DMD

  • Dentist
  • Englewood, CO
National Provider Identifier
1326009184
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7754 Issued in CO
Practice address
4107B S. Federal Blvd
Englewood, CO 80110-1198
Phone
(303) 501-6487
NPI assigned
Mar 31, 2006
Last updated
Aug 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7754 CO Primary

Addresses

Primary practice location

4107B S. Federal Blvd
Englewood, CO 80110-1198

Mailing address

9831 Foxhill Cir
Highlands Ranch, CO 80129-4320
Phone (720) 344-8541

Other identifiers 1

IdentifierTypeStateIssuer
02077543MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160302000808 CO Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 8729383617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7754COMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1326009184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9831 FOXHILL CIR",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "801294320",
            "telephone_number": "720-344-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107B S. FEDERAL BLVD",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801101198",
            "telephone_number": "303-501-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "ELSA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "7754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02077543",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, CO

Sources for this page

Verify at the official NPI Registry.