Active NPI
Anisabel D Lopez de Castro
- Dentist
- Port Charlotte, FL
National Provider Identifier
1972344836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN28989
- Practice address
- 21202 Olean Blvd
Port Charlotte, FL 33952-6751 - Phone
- (941) 629-3200
- NPI assigned
- Jun 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | DN28989 | FL | Primary |
Addresses
Primary practice location
21202 Olean Blvd
Port Charlotte, FL 33952-6751
Mailing address
2588 Talleyrand Ave
North Port, FL 34286-9073
Phone (786) 714-2136
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN28989 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1972344836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2588 TALLEYRAND AVE",
"city": "NORTH PORT",
"state": "FL",
"postal_code": "342869073",
"telephone_number": "786-714-2136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21202 OLEAN BLVD",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339526751",
"telephone_number": "941-629-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ DE CASTRO",
"first_name": "ANISABEL",
"middle_name": "D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-04",
"last_updated": "2024-06-04",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN28989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.