The Castleberry Center for Aesthetic Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19513 Issued in TX

Legal business name

THE CASTLEBERRY CENTER FOR AESTHETIC DENTISTRY

Practice address

138 Vintage Park Blvd
Suite #G
Houston, TX 77070

Phone

(713) 320-9166

NPI assigned

Jun 16, 2008

Organization subpart

No

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

Authorized official

Name

Darrick Lavone Castleberry

Title

Dentist

Phone

(713) 664-8000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1407016231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 VINTAGE PARK BLVD",
            "address_2": "SUITE #G",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77070",
            "telephone_number": "713-320-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 VINTAGE PARK BLVD",
            "address_2": "SUITE #G",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77070",
            "telephone_number": "713-320-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CASTLEBERRY CENTER FOR AESTHETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "CASTLEBERRY",
        "authorized_official_first_name": "DARRICK",
        "authorized_official_middle_name": "LAVONE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "713-664-8000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090849313",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.