McAllister Castelaz
Individual provider Active NPI Dentist · Milwaukee, WI
NPI 1972093128 · NPPES record last updated May 8, 2024
Key facts
- NPI
- 1972093128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 1002497 (WI)
- Practice address
- 1801 W Wisconsin Ave
Milwaukee, WI 53233-2186 - Phone
- (414) 288-6790
- NPI assigned
- May 14, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181004003116 | VA | Order and Referring Only - Dentist |
3476805250 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1002497 | WI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Horizon Health Services Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401416050 | VA | |
| Dentist | 122300000X | 1002497 | WI | Yes |
Addresses
Primary practice location
1801 W Wisconsin Ave
Milwaukee, WI 53233-2186
Mailing address
1845 Calvin CT
Iowa City, IA 52246-3104
Phone (216) 543-1287
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.