Eden Castillo Edora, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

51922 Issued in CA

Practice address

3315 Sonoma Blvd
Suite # 50
Vallejo, CA 94590-2967

Phone

(707) 552-4800

NPI assigned

Jul 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346266772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 TOSCANA DR",
            "city": "AMERICAN CANYON",
            "state": "CA",
            "postal_code": "945031470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 SONOMA BLVD",
            "address_2": "SUITE # 50",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945902967",
            "telephone_number": "707-552-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDORA",
        "first_name": "EDEN",
        "middle_name": "CASTILLO",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chinwe Maegan Echibe, PHARMD
• Nazila Tazangi Edalati, DDS
• Stephanie M. Eden, MD
• Editha M. Aquino D.M.D. Professional Dental Corporation
• Casnique Edmondson
• Eduardo M Abdala, M.D. Inc
• Angela Edwards
• James L. Edwards, MD
• Maurice Edwards
• Michael Francis Edziak, DDS

• General Practice Dentistry in Vallejo, CA
• Providers in Vallejo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.