Individual provider Active NPI

Johnna Lee Castedo, DDS

  • Student in an Organized Health Care Education/Training Program
  • Memphis, TN
National Provider Identifier
1831983576
Registry record updated Jun 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
875 Union Ave
Memphis, TN 38103-3513
Phone
(901) 448-6210
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12014749A IN
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

875 Union Ave
Memphis, TN 38103-3513

Mailing address

875 Union Ave
Memphis, TN 38103-3513
Phone (901) 448-6210

Other names 1

  • Johnna Lee Snider Former name

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
12014749AINMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749254400000",
    "number": "1831983576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033513",
            "telephone_number": "901-448-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033513",
            "telephone_number": "901-448-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTEDO",
        "first_name": "JOHNNA",
        "middle_name": "LEE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-06-07",
        "certification_date": "2025-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014749A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHNNA",
            "last_name": "SNIDER",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2025; 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.