Castle Pediatric Dentistry LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CASTLE PEDIATRIC DENTISTRY LLC

Practice address

5745 Canton CV Ste 101
Winter Springs, FL 32708-5012

Phone

(407) 755-4119

NPI assigned

Jun 28, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Keren E Castellucci, DMD

Title

Pediatric Dentist

Phone

(407) 383-6738

Specialties & licenses 1

Addresses

Other names 1

• Dr. Keren Castellucci Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keren Elizabeth Castellucci, D.M.D.

  • Pediatric Dentistry
  • Sebastian, FL
  • NPI 1558711655
  NPD

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1992375588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 APACHE TRL",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514906",
            "telephone_number": "407-383-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5745 CANTON CV STE 101",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085012",
            "telephone_number": "407-755-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASTLE PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "E CASTELLUCCI",
        "authorized_official_first_name": "KEREN",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "407-383-6738",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Keren Castellucci",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Ann Carlson, M.A.
• William Carlucci
• Sydney Faith Carpenter
• Alexius Carter, LCSW
• Charlie Casimir, COTA/L
• Amanda Castoire, MS
• Shirley Cezar
• Erika Renee Chace, M.S., ATC, LAT
• Ana Chamberlain, D.C.
• Theodore Champagne, MA

• All providers in Winter Springs, FL
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.