Active NPI
Joseph Serranzana Castro, D.D.S.
- General Practice Dentistry
- Fallston, MD
National Provider Identifier
1689735268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12217
- Practice address
- 2106 Fallston Rd
Fallston, MD 21047-1442 - Phone
- (410) 893-0513
- Fax
- (410) 893-7770
- NPI assigned
- Dec 13, 2006
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12217 | MD | Primary |
Addresses
Primary practice location
2106 Fallston Rd
Fallston, MD 21047-1442
Mailing address
3017 Duncan Rd
White Hall, MD 21161-8936
Phone (410) 893-0513
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12217 | Other | MD | MD STATE LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12217 | MD | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fallston Dental Care | General Practice | Past | Accepting new patients |
| Matthew E Winter DDS PA | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Fallston, MD
- NPI 1013033505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1689735268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3017 DUNCAN RD",
"city": "WHITE HALL",
"state": "MD",
"postal_code": "211618936",
"telephone_number": "410-893-0513",
"fax_number": "410-893-7770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2106 FALLSTON RD",
"city": "FALLSTON",
"state": "MD",
"postal_code": "210471442",
"telephone_number": "410-893-0513",
"fax_number": "410-893-7770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTRO",
"first_name": "JOSEPH",
"middle_name": "SERRANZANA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "12217",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD STATE LICENSE",
"identifier": "12217",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fallston, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.