Provider Demographics
NPI:1730294471
Name:CARASTRO, JOSEPH IV (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:CARASTRO
Suffix:IV
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 S PATTERSON AVE
Mailing Address - Street 2:#214
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2055
Mailing Address - Country:US
Mailing Address - Phone:805-964-4786
Mailing Address - Fax:805-964-4145
Practice Address - Street 1:122 S PATTERSON AVE
Practice Address - Street 2:#214
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2055
Practice Address - Country:US
Practice Address - Phone:805-964-4786
Practice Address - Fax:805-964-4145
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA445731223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics