Individual provider Active NPI

Blesyl Igaya Castillo, DDS

  • General Practice Dentistry
  • Menifee, CA
National Provider Identifier
1366008450
Registry record updated Jul 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS104229 Issued in CA
Practice address
30414 Town Center Dr Apt 1534
Menifee, CA 92584-6877
Phone
(619) 395-4864
NPI assigned
May 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS104229 CA Primary

Addresses

Primary practice location

30414 Town Center Dr Apt 1534
Menifee, CA 92584-6877

Mailing address

30414 Town Center Dr Apt 1534
Menifee, CA 92584-6877
Phone (619) 395-4864

Other practice location 1

10969 Wellworth Ave Apt 222
Los Angeles, CA 90024-6294
Phone (619) 395-4864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DDS104229CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593734400000",
    "number": "1366008450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30414 TOWN CENTER DR APT 1534",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925846877",
            "telephone_number": "619-395-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30414 TOWN CENTER DR APT 1534",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925846877",
            "telephone_number": "619-395-4864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10969 Wellworth Ave Apt 222",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900246294",
            "country_code": "US",
            "telephone_number": "619-395-4864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "BLESYL",
        "middle_name": "IGAYA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2020-07-03",
        "certification_date": "2020-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS104229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menifee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2020; 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.