1669886081 NPI number — ELIZABETH CASTANEDA, DMD, INC.

Table of content: (NPI 1669886081)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669886081 NPI number — ELIZABETH CASTANEDA, DMD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELIZABETH CASTANEDA, DMD, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669886081
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P. O. BOX 7800
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92615
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-981-1437
Provider Business Mailing Address Fax Number:
562-981-1438

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4342 ATLANTIC AVE.,
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-981-1437
Provider Business Practice Location Address Fax Number:
562-981-1438
Provider Enumeration Date:
06/13/2014

Additional Information

Authorized Official

Authorized Official Last Name:
CASTANEDA
Authorized Official First Name:
ELIZABETH
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
CEO/PRESIDENT
Authorized Official Telephone Number:
562-981-1437

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  33557 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com