Blanca Mairenys Castello Polo, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

DN20938 Issued in FL

Practice address

6491 Sunset Strip Ste 1
Sunrise, FL 33313-2867

Phone

(954) 572-1801

Fax

(954) 333-7561

NPI assigned

Sep 27, 2014

Last updated

Jun 8, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Networks

• Freedom Health HMO Network

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.

• Shalom Sunset Dental Care LLC

  • General Practice Dentistry
  • Sunrise, FL
  • NPI 1043661796
  NPD (past) Authorized official
• Tamarac Smile Center

  • Dental Clinic/Center
  • Tamarac, FL
  • NPI 1134901820
  NPD

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

{
    "created_epoch": "1411776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1710380316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6491 SUNSET STRIP STE 1",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333132867",
            "telephone_number": "954-572-1801",
            "fax_number": "954-333-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6491 SUNSET STRIP STE 1",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333132867",
            "telephone_number": "954-572-1801",
            "fax_number": "954-333-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLO POLO",
        "first_name": "BLANCA",
        "middle_name": "MAIRENYS",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-27",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Pascaline Casside
• Natalia Lorena Castano Cubillos
• Addara Castellanos
• Elissa Castellanos
• Lianet Castellanos
• Carla Sue Castiglione, L.D, R.D.
• Clara Castillo
• Isabela Carolina Castillo
• Claudia Castro Molina
• Jenisse Castro

• Dentist in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.