Provider Demographics
NPI:1225655335
Name:JAIRO CASTRO, D.D.S., INC.
Entity Type:Organization
Organization Name:JAIRO CASTRO, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-401-3000
Mailing Address - Street 1:1723 DURFEE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-4557
Mailing Address - Country:US
Mailing Address - Phone:626-401-3000
Mailing Address - Fax:626-416-5433
Practice Address - Street 1:1723 DURFEE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-4557
Practice Address - Country:US
Practice Address - Phone:626-401-3000
Practice Address - Fax:626-416-5433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental