Provider Demographics
NPI:1760162473
Name:CASTANEDA CARPIO, ADRIANA CAROLINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:CAROLINA
Last Name:CASTANEDA CARPIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 E WOOLBRIGHT RD
Mailing Address - Street 2:APT 514
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435
Mailing Address - Country:US
Mailing Address - Phone:704-787-2436
Mailing Address - Fax:
Practice Address - Street 1:10075 S JOG RD STE 108
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3532
Practice Address - Country:US
Practice Address - Phone:561-738-9007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL282051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice