Active NPI
Andreina Maria Castro, DDS,MS
- Pediatric Dentistry
- Taylor, MI
National Provider Identifier
1770701583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 2901017364
- Practice address
- 21213 Ecorse Rd
Taylor, MI 48180-1834 - Phone
- (313) 292-7777
- Fax
- (313) 292-7515
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 2901017364 | MI | Primary |
Addresses
Primary practice location
21213 Ecorse Rd
Taylor, MI 48180-1834
Mailing address
21213 Ecorse Rd
Taylor, MI 48180-1834
Phone (313) 292-7777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160810001780 | MI | Order and Referring Only - Other (Physician) | 2668766817 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901017364 | MI | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golnick Pediatric Dental Associates | 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.
-
- Dental Clinic/Center
- Taylor, MI
- NPI 1548444102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770701583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21213 ECORSE RD",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481801834",
"telephone_number": "313-292-7777",
"fax_number": "313-292-7515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21213 ECORSE RD",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481801834",
"telephone_number": "313-292-7777",
"fax_number": "313-292-7515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTRO",
"first_name": "ANDREINA",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "DDS,MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MI",
"license": "2901017364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.