Individual provider Active NPI

Erin Castre, D.M.D.

  • Dentist
  • Scottsdale, AZ
National Provider Identifier
1407260839
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9294 Issued in AZ
Practice address
10260 N 90TH St
Scottsdale, AZ 85258-4408
Phone
(815) 245-4263
NPI assigned
Jun 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7235-15 WI
Dentist 122300000X 9294 AZ Primary

Addresses

Primary practice location

10260 N 90TH St
Scottsdale, AZ 85258-4408

Mailing address

2629 E Elm St
Phoenix, AZ 85016-4812
Phone (815) 245-4263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20160929001611 AZ Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6305133638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7235-15WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Scottsdale Modern Dentistry and Orthodontics, LLP General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1407260839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 E ELM ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164812",
            "telephone_number": "815-245-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10260 N 90TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584408",
            "telephone_number": "815-245-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRE",
        "first_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "7235-15",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "9294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.