Active NPI
Myro Castillo, DDS
- Dentist
- Riverside, CA
National Provider Identifier
1861211575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 110899
- Practice address
- 10286 Indiana Ave
Riverside, CA 92503 - Phone
- (559) 415-9383
- NPI assigned
- Oct 9, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 110899 | CA | Primary |
Addresses
Primary practice location
10286 Indiana Ave
Riverside, CA 92503
Mailing address
26679 Eureka Street
Loma Linda, CA 92373
Phone (559) 415-9383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- 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 |
|---|---|---|---|---|
| I20250808002727 | CA | Order and Referring Only - Dentist | 5698273670 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728432000000",
"number": "1861211575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26679 EUREKA STREET",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "92373",
"telephone_number": "559-415-9383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10286 INDIANA AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "92503",
"telephone_number": "559-415-9383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTILLO",
"first_name": "MYRO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-10-09",
"last_updated": "2024-10-09",
"certification_date": "2024-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "110899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.