Carlos Andres Castro-Perdomo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013764 Issued in GA

Practice address

1942 Atkinson Rd
Suite 500
Lawrenceville, GA 30043-5003

Phone

(917) 907-2185

NPI assigned

Aug 18, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

State licenses

Practice roles

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.

• Ga Prostho LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Duluth, GA
  • NPI 1942140074
  NPD

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1780831016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 ATKINSON RD",
            "address_2": "SUITE 500",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435003",
            "telephone_number": "917-907-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 ATKINSON RD",
            "address_2": "SUITE 500",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435003",
            "telephone_number": "917-907-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO-PERDOMO",
        "first_name": "CARLOS",
        "middle_name": "ANDRES",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-18",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013764",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "DN013764",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "056055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Murtaza Cassoobhoy, MD
• Amy E. Castaline
• Alicia Castellano, MS, CCC-SLP
• Ramon Elias Castillo Perez, CMI: SPANISH
• Leigh Anne Castleberry
• Catalyst RX Pharmacy LLC
• Samantha Catoggio
• Matthew Caudill, LCSW
• Justin Derek Caughron, MD
• Jessica N Cavallo, OT

• General Practice Dentistry in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; 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.