DR. GRACIE CASTILLO (NPI# 1013420967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013420967 |
| Entity Type | Individual |
| Full Name | DR. GRACIE CASTILLO |
| Credential | DDS |
| Practice Address |
4277 W El Segundo Blvd Hawthorne CA 90250-4548 |
| Mailing Address |
11900 Goshen Ave Apt 103 Los Angeles CA 90049-6379 |
| Practice Telephone | 3109700200 |
| Mailing Telephone | 8318401201 |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
102077 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710120811 | Gracie Ann Castillo | Physician Assistant | 6624 Fannin St, 2600, Houston, TX 77030-2312 | 2009-04-20 |
| Street Address |
4277 W EL SEGUNDO BLVD |
| City | HAWTHORNE |
| State | CA |
| Zip Code | 90250-4548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578620407 | Heydar Shahrokh | Dentist | 4277 W El Segundo Blvd, Hawthorne, CA 90250-4548 | 2007-01-02 |
| 1790200160 | Alabbas Hussain | Dentist | 4277 W El Segundo Blvd, Hawthorne, CA 90250-4548 | 2017-08-07 |
| 1700240793 | Heydar Shahrokh Dds Inc | Dentist | 4277 W El Segundo Blvd, Hawthorne, CA 90250-4548 | 2016-04-06 |
| 1699069245 | Reza Sadeghi | Dentist | 4277 W El Segundo Blvd, Hawthorne, CA 90250-4548 | 2011-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508479627 | Alexis Lemmon | Dental Hygienist | 13450 Hawthrone Blvd, Hawthorne, CA 90250 | 2020-08-28 |
| 1336620459 | Lan Ngoc Ton | Dentist | 13450 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2018-08-27 |
| 1356829261 | Karneth Health Inc | Internal Medicine | 4512 W. Imperial Hwy, Ste B, Hawthorne, CA 90250 | 2018-08-02 |
| 1225524663 | Viridian Healthcare LLC | In Home Supportive Care | 13658 Hawthorne Blvd Ste 201, Hawthorne, CA 90250 | 2018-07-09 |
| 1235636044 | Sonia Medical Center Inc | Clinic/Center | 4512 W Imperial Hwy, Hawthorne, CA 90250 | 2018-04-09 |
| 1518484807 | Jessica Anne-marie Auzenne-harris | Nurse Practitioner | 12618 Hawthorne Blvd, Hawthorne, CA 90250 | 2017-08-28 |
| 1669993358 | Ololade Olamide Obafemi | Nurse Practitioner | 12954 Hawthorne Boulevard, Suite 104, Hawthorne Morningside Medical Clinic, Hawthorne, CA 90250 | 2017-07-03 |
| 1588194534 | Marissam Medical Inc. | Durable Medical Equipment & Medical Supplies | 13508 Inglewood Ave, Hawthorne, CA 90250 | 2017-06-13 |
| 1043751886 | Ogbonna Iwuamadi Olelewe | Nurse Practitioner | 11712 S. Hawthorne Blvd, Hawthorne, CA 90250 | 2017-03-13 |
| 1952758898 | La Shada Kai Martin | Contractor | 13010 Kornblum Ave, Unit D, Hawthorne, CA 90250 | 2016-05-20 |
| Find all providers in zip 90250 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477978823 | N.bimbli, D.d.s, A Professional Dental Corporation | Dentist | 13901 Hawthorne Blvd, Hawthorne, CA 90250-7001 | 2014-02-21 |
| 1285941260 | Melanie Ngov | Dentist | 13505 Hawthorne Blvd, Hawthorne, CA 90250-5807 | 2010-09-11 |
| 1457679847 | The Smile Spa of North Jersey,llc | Dentist | 759 Lafayette Ave, Hawthorne, NJ 07506-2855 | 2010-05-10 |
| 1124200399 | Jane L. Jager | Dentist | 375 Lafayette Ave, Hawthorne, NJ 07506-2544 | 2007-11-29 |
| 1992906242 | Nikolin Spiro Bimbli | Dentist | 13402 Hawthorne Blvd, Hawthorne, CA 90250-5806 | 2007-05-31 |
| 1982821666 | James Myung Ju Kim | Dentist | 3800 W El Segundo Blvd, Ste 203, Hawthorne, CA 90250-4677 | 2007-04-20 |
| 1467676866 | Ehab F. Ismail,inc | Dentist | 13637 Hawthorne Blvd, Suite #101, Hawthorne, CA 90250-5812 | 2007-04-13 |
| 1386868503 | Susan Manavi, Dds, Inc | Dentist | 12730 Hawthorne Blvd Ste D, Hawthorne, CA 90250-3919 | 2007-04-11 |
| 1598898728 | Ramesh Mulchandani D.d.s | Dentist | 12223 Hawthorne Blvd, Hawthorne, CA 90250-3807 | 2007-03-14 |
| 1760510010 | Lourdes Mangohig Villanueva | Dentist | 4559 W Rosecrans Ave, Hawthorne, CA 90250-6935 | 2007-03-01 |
| Find all providers in HAWTHORNE | ||||
Please comment or provide details below to improve the information on DR. GRACIE CASTILLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.