Provider Demographics
NPI:1538448196
Name:CASTRO, RAYNATO OCAMPO JR (DDS)
Entity type:Individual
Prefix:
First Name:RAYNATO
Middle Name:OCAMPO
Last Name:CASTRO
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1480 KILDARE WAY
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2712
Mailing Address - Country:US
Mailing Address - Phone:510-260-4943
Mailing Address - Fax:
Practice Address - Street 1:2089 VALE RD
Practice Address - Street 2:STE 30
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3847
Practice Address - Country:US
Practice Address - Phone:510-236-1662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA605861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice