Active NPI
David Castillo, D.D.S
- Dentist
- Moreno Valley, CA
National Provider Identifier
1972866176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 49735
- Practice address
- 12900 Perris Blvd
Suite 101
Moreno Valley, CA 92553-4135 - Phone
- (951) 317-9906
- NPI assigned
- Jun 21, 2012
- Last updated
- Jun 12, 2013
- Sex
- Male
- 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 | 49735 | CA | Primary |
Addresses
Primary practice location
12900 Perris Blvd
Suite 101
Moreno Valley, CA 92553-4135
Mailing address
7353 Ellena W
Unit 110
Rancho Cucamonga, CA 91730-8356
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 |
|---|---|---|---|
| 49735 | CA | MD | Dentist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370995200000",
"number": "1972866176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7353 ELLENA W",
"address_2": "UNIT 110",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917308356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12900 PERRIS BLVD",
"address_2": "SUITE 101",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925534135",
"telephone_number": "951-317-9906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTILLO",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-21",
"last_updated": "2013-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "49735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.