Provider Demographics
NPI:1497291108
Name:CASTELLINI, ROBERTO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:CASTELLINI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ROBERTO
Other - Middle Name:J
Other - Last Name:CASTELLINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:7350 SANDLAKE COMMONS BLVD STE 1121
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:407-351-0556
Practice Address - Street 1:7350 SANDLAKE COMMONS BLVD STE 1121
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8031
Practice Address - Country:US
Practice Address - Phone:407-351-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-19
Last Update Date:2019-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 223831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1497291108Medicaid