Individual provider Active NPI

Cassio Castro, D.M.D.

  • General Practice Dentistry
  • Denver, CO
National Provider Identifier
1689961765
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN.00203571 Issued in CO
Practice address
1573 S Broadway
Denver, CO 80210-2607
Phone
(303) 333-1844
NPI assigned
Jul 8, 2011
Last updated
Dec 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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 DEN.00203571 CO Primary

Addresses

Primary practice location

1573 S Broadway
Denver, CO 80210-2607

Mailing address

9691 E Iowa Ave
Denver, CO 80247-3090
Phone (954) 290-2396

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
DEN.00203571COMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Broadway Family Dentistry & Implants ,PLLC General Practice CurrentSince Dec 17, 2023 Accepting new patients
Direct Mobile Dental Services, Inc. General Practice PastSince Apr 25, 2021 Accepting new patients
Ccdi Denver PDC PLLC PastSince Dec 17, 2023 Accepting new patients

Locations

1573 S Broadway
Denver, CO 80210
Phone (303) 333-1844

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1689961765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9691 E IOWA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802473090",
            "telephone_number": "954-290-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 S BROADWAY",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802102607",
            "telephone_number": "303-333-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "CASSIO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00203571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.

Verify at the official NPI Registry.