Jorge Enrique Mosquera Castrillon, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019032932 Issued in IL

Practice address

687 E Linton Ave
Springfield, IL 62703-5902

Phone

(718) 909-2550

NPI assigned

Oct 2, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dr Mosquera Prosthodontics PLLC

  • Dental Clinic/Center
  • Springfield, IL
  • NPI 1114608965
  NPD Authorized official
• Philco Dental Group LLC - Champaign

  • General Practice Dentistry
  • Champaign, IL
  • NPI 1548772114
  NPD (past)
• Philco Dental Group LLC - Springfield

  • General Practice Dentistry
  • Springfield, IL
  • NPI 1003328675
  NPD (past)

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1871190884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 SANDPIPER DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627116722",
            "telephone_number": "561-635-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 E LINTON AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035902",
            "telephone_number": "718-909-2550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 N Dirksen Pkwy",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627021407",
            "country_code": "US",
            "telephone_number": "217-492-1400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1902 N Prospect Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618221411",
            "country_code": "US",
            "telephone_number": "217-204-9025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSQUERA CASTRILLON",
        "first_name": "JORGE",
        "middle_name": "ENRIQUE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-02",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019032932",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "021003081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mosaic Clinical Counseling LLC
• Lateefat Abiodun Mosaku
• Demetria J Moscardelli, LCSW
• Marcelon Alexzander Mosley
• Robert G. Mosley, M.D.
• Nicole R Moss, APRN
• Mosser Corporation
• Lyndsie Patricia Most-Gephart, COTA
• Mother Tree Counseling LLC
• Hannah Motley

• Dentist in Springfield, IL
• Providers in Springfield, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.