NPIMap

Organization Active NPI

Mid Ohio Dental Associates

  • Dentist
  • Columbus, OH
National Provider Identifier
1619086717
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30016727 Issued in OH
Legal business name
MID OHIO DENTAL ASSOCIATES
Doing business as
Mid Ohio Dental Associates
Practice address
3079 W. Broad Ste Suite 7
Columbus, OH 43204
Phone
(614) 279-9204
Fax
(614) 279-9208
NPI assigned
Aug 30, 2006
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Jack Daniel Castilla, DDSNPI 1841529336
Title
Dentist
Phone
(614) 279-9204

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 30016727 OH Primary

Addresses

Primary practice location

3079 W. Broad Ste Suite 7
Columbus, OH 43204

Mailing address

3079 W. Broad Ste Suite 7
Columbus, OH 43204
Phone (614) 279-9204

Other names 1

  • Mid Ohio Dental Associates Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1619086717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3079 W. BROAD STE SUITE 7",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43204",
            "telephone_number": "614-279-9204",
            "fax_number": "614-279-9208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3079 W. BROAD STE SUITE 7",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "43204",
            "telephone_number": "614-279-9204",
            "fax_number": "614-279-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID OHIO DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-09-02",
        "status": "A",
        "authorized_official_last_name": "CASTILLA",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "614-279-9204",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "30016727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid Ohio Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.