Provider Demographics
NPI:1003445560
Name:J CASTELO DDS, INC
Entity type:Organization
Organization Name:J CASTELO DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CHAN
Authorized Official - Last Name:CASTELO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-666-3852
Mailing Address - Street 1:5755 E KINGS CANYON RD STE 108
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-4744
Mailing Address - Country:US
Mailing Address - Phone:559-251-4281
Mailing Address - Fax:559-251-4281
Practice Address - Street 1:5755 E KINGS CANYON RD STE 108
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-4744
Practice Address - Country:US
Practice Address - Phone:559-251-4281
Practice Address - Fax:559-251-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-06
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1144467341OtherNPI TYPE1