Provider Demographics
NPI:1790888733
Name:CASTANEDA, ALBERTO RAMON (DDS FAGD)
Entity Type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:RAMON
Last Name:CASTANEDA
Suffix:
Gender:M
Credentials:DDS FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7214 PFLUMM RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-4110
Mailing Address - Country:US
Mailing Address - Phone:913-268-1337
Mailing Address - Fax:
Practice Address - Street 1:1229 SW STATE ROUTE 7
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-3539
Practice Address - Country:US
Practice Address - Phone:816-897-7407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS67961223G0001X
MO20150428111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice